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Restoration of humoral immunity after intravenous immunoglobulin replacement therapy in heart recipients with post‐transplant antibody deficiency and severe infections
Author(s) -
Carbone J.,
Sarmiento E.,
Del Pozo N.,
RodriguezMolina J.J.,
Navarro J.,
FernandezYañez J.,
Palomo J.,
Villa A.,
Muñoz P.,
FernandezCruz E.
Publication year - 2012
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/j.1399-0012.2012.01653.x
Subject(s) - medicine , hypogammaglobulinemia , antibody , immunology , heart transplantation , immunity , intravenous immunoglobulin therapy , humoral immunity , population , transplantation , immune system , environmental health
IgG hypogammaglobulinemia is a risk factor for infection in heart recipients. We assessed reconstitution of humoral immunity after non‐specific intravenous immunoglobulin ( IVI g) replacement therapy administered to treat secondary IgG hypogammaglobulinemia in heart recipients with severe infections. The study population comprised 55 heart recipients who were administered IVI g ( IVI g group) and 55 heart recipients with no severe infectious complications (control group). An event was defined as a severe infection requiring intravenous drug therapy during the first year after transplantation. The IVI g protocol comprised non‐specific 5% pasteurized IVI g at a dose of 300–400 mg/kg/months. IgG titers were lower in the IVI g group than in controls at seven d (577 vs. 778 mg/dL, p < 0.001) and at one month (553 vs. 684, p = 0.003). After IVI g therapy, IgG concentrations were similar in both groups at three months (681 vs. 737, p = 0.25) and at six months (736 vs. 769, p = 0.46). At three months, the IVI g group had higher levels of antitetanus toxoid and anti‐ HB s ( ELISA , 2.07 ± 2.11 vs. 0.60 ± 1.24 mg/dL [p = 0.003] and 42 ± 40 vs. 11 ± 31 IU /mL [p = 0.005], respectively) than controls. The mean number of infectious complications was significantly lower after IVIG therapy in the IVIG group. IVI g was associated with restoration of humoral immunity in heart recipients with post‐transplant IgG hypogammaglobulinemia and severe infections.