Yildiz UCAR, Aynur SAHIN, Dorina ESENDAGLI, Polina NEZALZOVA, Emre KARAKAYA, Gaye ULUBAY, Mehmet HABERAL
Experimental and Clinical Transplantation - 2026;24(7):535-546
Objectives: Infections, especially pneumonia, are among the significant causes of morbidity and mortality in transplant recipients. Pneumonia leads to a complex clinical picture, related not only to the infection itself but also to underlying immunosuppression, concomitant diseases, and organ dysfunction. Here, we evaluated the effect of the HALP score (ie, hemoglobin, albumin, lymphocyte, and platelet) on prognosis in patients who developed pneumonia after kidney transplant. Materials and Methods: We retrospectively reviewed files of kidney transplant recipients in the chest diseases outpatient clinic of our hospital who were diagnosed with pneumonia on thoracic computed tomography scans between April 2020 and April 2025. We exported data (age, sex, laboratory test results at diagnosis, duration of hospitalization, and mortality rate) to a database spreadsheet file (Excel) and compared hemoglobin, albumin, lymphocyte, and platelet scores of patients who died versus survived. We analyzed disease severity by classification according to the Pneumonia Severity Index and CURB-65 (ie, confusion, uremia, respiratory rate, blood pressure, and age >=65) scores. Results: Among 178 included patients (100 female, 78 male), 148 survived (83.1%) and 30 died (16.9%). Patients who died had lower hemoglobin, albumin, lymphocyte, and platelet scores than patients who survived. Patients with higher Pneumonia Severity Index scores had significantly lower hemoglobin, albumin, lymphocyte, and platelet scores. Conclusions: The hemoglobin, albumin, lymphocyte, and platelet score is a biomarker based on easily calculable, low-cost, and accessible parameters and may be a potential tool for evaluation of prognosis in the general patient population. Prospective and multicenter studies with larger sample groups are needed to better evaluate the role of the hemoglobin, albumin, lymphocyte, and platelet score for determination of the prognosis related to infections in kidney transplant recipients.
