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Hypogammaglobulinemia following heart transplantation: Prevalence, predictors, and clinical importance
Author(s) -
Fujino Takeo,
Kumai Yuto,
Nitta Daisuke,
Holzhauser Luise,
Nguyen Ann,
Lourenco Laura,
Rodgers Daniel,
Raikhelkar Jayant,
Kim Gene,
Sayer Gabriel,
Uriel Nir
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14087
Subject(s) - medicine , hypogammaglobulinemia , heart transplantation , transplantation , incidence (geometry) , multivariate analysis , retrospective cohort study , gastroenterology , immunology , antibody , physics , optics
Hypogammaglobulinemia (HGG) can occur following solid organ transplantation. However, there are limited data describing the prevalence, risk factors, and clinical outcomes associated with HGG following heart transplantation. We retrospectively reviewed data of 132 patients who had undergone heart transplantation at our institution between April 2014 and December 2018. We classified patients into three groups based on the lowest serum IgG level post‐transplant: normal (≥700 mg/dL), mild HGG (≥450 and <700 mg/dL), and severe HGG (<450 mg/dL). We compared clinical outcomes from the date of the lowest IgG level. Mean age was 57 (47, 64) years, and 94 (71%) patients were male. Prevalence of severe HGG was the highest (27%) at 3‐6 months following heart transplantation and then decreased to 5% after 1 year. Multivariate analysis showed that older age and Caucasian race were independent risk factors for HGG. Overall survival was comparable between the groups; however, survival free of infection was 73%, 60%, and 45% at 1 year in the normal, mild HGG, and severe HGG groups, respectively ( P = .013). In conclusion, there is a high prevalence of HGG in the early post‐heart transplant period that decreases over time. HGG is associated with an increased incidence of infection.