Does increasing immunoglobulin levels impact survival in solid organ transplant recipients with hypogammaglobulinemia?. (15th October 2014)

• Record Type: Journal Article
• Authors: Florescu, Diana F.; Kalil, Andre C.; Qiu, Fang; Grant, Wendy; Morris, Michael C.; Schmidt, Cynthia M.; Florescu, Marius C.; Poole, Jill A.
• Is Part Of: Clinical transplantation. Volume 28:Number 11(2014)
• Page Start: 1249
• Page End: 1255
• Publication Date: 2014-10-15
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12458
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12458-abs-0001"> <title>Abstract</title> <sec id="ctr12458-sec-0001" sec-type="section"> <title>Background</title> <p>Severe hypogammaglobulinemia (IgG < 400 mg/dL) has adverse impact on mortality during the first year post‐transplantation. The aim of the study was to determine whether increasing IgG levels to ≥400 mg/dL improved outcomes.</p> </sec> <sec id="ctr12458-sec-0002" sec-type="section"> <title>Methods</title> <p>Kaplan–Meier analyses were performed to estimate survival, log‐rank test to compare survival distributions between groups, and Fisher's exact test to determine the association between hypogammaglobulinemia and rejection or graft loss.</p> </sec> <sec id="ctr12458-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty‐seven solid organ transplant (SOT) recipients were included. Hypogammaglobulinemia was diagnosed at median of 5.6 months (range: 0–291.8 months) post‐transplantation. Types of transplants: liver–small bowel (17); liver–small bowel–kidney (2); liver (5); small bowel (4); liver–kidney (1); kidney/kidney–pancreas (3); heart (3); heart–kidney (1); and heart–lung (1). The three‐yr survival after the diagnosis of hypogammaglobulinemia was 49.5% (95% CI: 32.2–64.6%). Patients were dichotomized based upon IgG level at last follow‐up: IgG ≥ 400 mg/dL (23 patients) and IgG < 400 mg/dL (14 patients). There was no evidence of a difference in survival (p = 0.44), rejection rate (p = 0.44), and graft loss censored for death (p = 0.99) at one yr between these two groups. There was no difference in survival between patients receiving or not immunoglobulin (p = 0.99) or cytomegalovirus hyperimmunoglobulin (p = 0.14).</p> </sec> <sec id="ctr12458-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Severe hypogammaglobulinemia after SOT is associated with high mortality rates, but increasing IgG levels to ≥400 mg/dL did not seem to translate in better patient or graft survival in this cohort.</p> </sec> </abstract>