■低球蛋白血症(HGG),免疫球蛋白G(IgG)<700mg/dL,与感染有关,慢性肺移植功能障碍,和肺移植后的死亡。这项研究评估了按需静脉内IgG在HGG肺移植受者中的使用。
■这项针对成年肺部受者的单中心回顾性队列研究评估了3组,不,未经处理(u),或在第一次IgG施用或移植后的匹配时间处理(t)HGG。主要结果是无同种异体移植功能障碍。次要结果包括晚期功能障碍的发展,拒绝,感染负担,和死亡率。
■收件人包括484个(无HGG:76,uHGG:192,tHGG:216)。非HGG组在入组2年后无慢性同种异体图功能障碍的发生率最高(无HGG77.9%vsuHGG56.4%vstHGG52.5%;P=.002)。入学后2年,无晚期功能障碍的情况存在显着差异(无HGG90.5%vsuHGG84.7%vstHGG75.4%;P=.017)。无HGG和有uHGG的患者在入组后2年死亡率较低(无HGG84.2%vsuHGG81.3%vstHGG64.8%;P<.001)。革兰氏阴性肺炎在tHGG组中更常见(P=0.02)。
■慢性肺移植功能障碍的发展,患者生存,拒绝负担,在按需IgG治疗的情况下,肺移植受者的关键感染结局仍然存在问题.前瞻性研究是有必要的。
UNASSIGNED: Hypogammaglobulinemia (HGG), immunoglobulin G (IgG) <700 mg/dL, is associated with infections, chronic lung allograft dysfunction, and death following lung transplantation. This study evaluates the use of on-demand intravenous IgG in lung transplant recipients with HGG.
UNASSIGNED: This single-center retrospective cohort study of adult lung recipients evaluated 3 groups, no, untreated (u), or treated (t) HGG at first IgG administration or a matched time posttransplant. Primary outcome was freedom from allograft dysfunction. Secondary outcomes included development of advanced dysfunction, rejection, infection burden, and mortality.
UNASSIGNED: Recipients included 484 (no HGG: 76, uHGG: 192, tHGG: 216). Freedom from chronic allograph dysfunction was highest in the non-HGG group 2 years post-enrollment (no HGG 77.9% vs uHGG 56.4% vs tHGG 52.5%; P = .002). Freedom from advanced dysfunction was significantly different 2 years post-enrollment (no HGG 90.5% vs uHGG 84.7% vs tHGG 75.4%; P = .017). Patients without HGG and those with uHGG had less mortality at 2 years post-enrollment (no HGG 84.2% vs uHGG 81.3% vs tHGG 64.8%; P < .001). Gram-negative pneumonias occurred more often in the tHGG group ( P = .02).
UNASSIGNED: Development of chronic lung allograft dysfunction, patient survival, rejection burden, and key infectious outcomes in lung transplant recipients were still problematic in the context of on-demand IgG therapy. Prospective studies are warranted.