October 30, 2012

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


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Up to one-third of transplant recipients can develop hypogammaglobulinemia. However, it is controversial whether the presence of hypogammaglobulinemia leads to an increased risk of infections. Further, many transplant centers do not do routine monitoring for this. The authors of this paper prospectively monitored 226 kidney transplant patients at 0, 1, 6 months post-transplant. At one month, just over half of the patients had hypogammaglobulinemia. Greater incidences of infection especially bacteremia and acute pyelonephritis were found in the first 6 months post-transplant for those with hypogammaglobulinemia. This was also an independent risk factor for overall infections. The authors suggest that measurement of serum immunoglobulins can be used as a nonspecific marker for immune status. It is important to note that measurement of gammaglobulins was not predictive of viral infections and it is unknown whether replacement therapy would be cost-effective or beneficial in the reduction of infection. The authors also did not measure cellular immunity which may be more important for some infections.

Transplant Infectious Disease

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