Intravenous immunoglobulin in heart transplant recipients with mild to moderate hypogammaglobulinemia and infection

• Published in: Clinical transplantation Vol. 36; no. 4; pp. e14571 - n/a
• Main Authors: Hoang, Johnny, Krisl, Jill, Moaddab, Mozhgon, Nguyen, Duc T., Graviss, Edward A., Hussain, Imad, Kassi, Mahwash, Yousefzai, Rayan, Kim, Ju, Trachtenberg, Barry, Bhimaraj, Arvind, Guha, Ashrith
• Format: Journal Article
• Language: English
• Published: Denmark 01.04.2022
• Subjects: Agammaglobulinemia - drug therapy; Agammaglobulinemia - etiology; heart transplantation; Heart Transplantation - adverse effects; Humans; hypogammaglobulinemia; Immunoglobulin G; Immunoglobulins, Intravenous - therapeutic use; infection; Retrospective Studies; Transplant Recipients; heart transplantation; infection; hypogammaglobulinemia
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.14571

Background Hypogammaglobulinemia (HGG) is a complication of solid organ transplantation leading to increased risk of infections. Intravenous immunoglobulin G (IVIG) replacement in patients with HGG may be able to reduce risk and morbidity associated with infection; however, there is scarce data about IVIG in mild to moderate HGG (IgG 400–700 mg/dl) and heart transplant recipients. Methods A single center, retrospective study was performed in heart transplant recipients with mild (IgG 500–700 mg/dl) to moderate (IgG 400–499 mg/dl) HGG in the presence of an infection. Results Forty‐two patients were included in this study; 19 patients (45.2%) received IVIG and 23 (54.8%) patients did not. Patients in the IVIG group received on average one dose of IVIG at 0.5 g/kg. No differences in incidence of new infection at 3 months (26.3% vs. 17.4%; P = .71) and 6 months (42.1% vs. 34.8%; P = .63) were observed between the IVIG and non‐IVIG groups. Infections based on mild or moderate HGG also had no differences at 3 and 6 months. Conclusion Our findings suggest that a single infusion of IVIG in mild to moderate HGG may have little to no benefit in reducing incidence of new infections. Larger prospective studies are needed to confirm these findings.