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Free Content Monitoring of Immunoglobulin Levels Identifies Kidney Transplant Recipients at High Risk of Infection

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We aimed to analyze the incidence, risk factors and impact of hypogammaglobulinemia (HGG) in 226 kidney transplant (KT) recipients in which serum immunoglobulin (Ig) levels were prospectively assessed at baseline, month 1 (T1), and month 6 (T6). The prevalence of IgG HGG increased from 6.6% (baseline) to 52.0% (T1) and subsequently decreased to 31.4% (T6) (p < 0.001). The presence of IgG HGG at baseline (odds ratio [OR] 26.9; p = 0.012) and a positive anti‐HCV status (OR 0.17; p = 0.023) emerged as risk factors for the occurrence of posttransplant IgG HGG. Patients with HGG of any class at T1 had higher incidences of overall (p = 0.018) and bacterial infection (p = 0.004), bacteremia (p = 0.054) and acute pyelonephritis (p = 0.003) in the intermediate period (months 1–6). Patients with HGG at T6 had higher incidences of overall (p = 0.004) and bacterial infection (p < 0.001) in the late period (>6 month). A complementary log–log model identified posttransplant HGG as an independent risk factor for overall (hazard ratio [HR] 2.03; p < 0.001) and bacterial infection (HR 2.68; p < 0.0001). Monitoring of humoral immunity identifies KT recipients at high risk of infection, offering the opportunity for preemptive immunoglobulin replacement therapy.
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Document Type: Research Article

Affiliations: 1: Department of Immunology, Hospital Universitario “12 de Octubre”. Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense. Madrid, Spain 2: Department of Nephrology. Hospital Universitario “12 de Octubre”. Instituto de Investigación Hospital “12 de Octubre” (i+12). School of Medicine, Universidad Complutense. Madrid, Spain

Publication date: October 1, 2012

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