Monitoring of immunoglobulin levels identifies kidney transplant recipients at high risk of infection [artículo]
Por: Aguado García, José María [Enfermedades Infecciosas]
| Andrés Belmonte, Amado [Nefrología] | Fernández Ruiz, Mario [Medicina Interna] | García Reyne, Ana [Medicina Interna] | González Monte, Esther [Nefrología] | López Medrano, Francisco [Enfermedades Infecciosas] | Lora Pablos, David [Instituto Investigación I+12] | Lumbreras Bermejo, Carlos [Medicina Interna] | Morales Cerdán, José María [Nefrología] | Paz Artal, Estela [Inmunología] | San Juan Garrido, Rafael [Medicina Interna].
Colaborador(es): Servicio de Medicina Interna | Servicio de Inmunología | Servicio de Nefrología | Instituto de Investigación imas12.
Editor: American Journal of Transplantation, 2012Descripción: 12(10):2763-2773.Recursos en línea: Solicitar documento Resumen: 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 (T(1) ), and month 6 (T(6) ). The prevalence of IgG HGG increased from 6.6% (baseline) to 52.0% (T(1) ) and subsequently decreased to 31.4% (T(6) ) (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 T(1) 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 T(6) 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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Artículo
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Formato Vancouver:
Fernández-Ruiz M, López-Medrano F, Varela-Peña P, Lora-Pablos D, García-Reyne A, González E, et al. Monitoring of immunoglobulin levels identifies kidney transplant recipients at high risk of infection. Am J Transplant. 2012;12(10):2763-73.
PMID: 22823002
Contiene 37 referencias
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 (T(1) ), and month 6 (T(6) ). The prevalence of IgG HGG increased from 6.6% (baseline) to 52.0% (T(1) ) and subsequently decreased to 31.4% (T(6) ) (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 T(1) 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 T(6) 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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