A clinical trial coordinated by the Universidad Autónoma de Madrid (UAM) suggests that the early administration of intravenous immunoglobulin (IVIG) could decrease the occurrence of new infections in transplanted individuals who present hypogammaglobulinemia.
The work, published in the journal "Transplantation Direct" and carried out with the collaboration of several Spanish hospitals, focused on patients who had suffered a severe infection after transplantation and showed a concentration of IgG below 600 mg/dL.
Infections are a very common complication after transplantation and, in general, are addressed with antimicrobial treatments. However, a portion of the patients experiences infectious episodes again during follow-up. This risk is particularly high in those who present hypogammaglobulinemia, an alteration of the immune system defined by reduced levels of immunoglobulin G (IgG).
In the trial, participants were randomly assigned to two groups. All received the standard antimicrobial regimen, but one of the groups was also treated with five doses of IVIG administered over about three months. At the end of the observation period, the research team analyzed and compared the incidence of new infections between both groups.
The data obtained indicate that complementing conventional treatment with IVIG can significantly decrease the likelihood of suffering new infections. Likewise, this intervention was associated with an increase in the concentrations of different antibodies directed against various microorganisms.
Implications for clinical practice
According to the authors, these results support a possible therapeutic strategy: administering IVIG to transplanted patients who develop a severe infection and present an IgG concentration lower than 600 mg/dL. As this is a phase 2 trial, it will be necessary to confirm these findings in studies with a larger number of participants before considering their widespread incorporation into clinical practice.
The study involved the Hospital General Universitario Gregorio Marañón, the Hospital Universitario Puerta de Hierro Majadahonda, and the Hospital Universitario 12 de Octubre, in Madrid; the Hospital Universitario Marqués de Valdecilla, in Santander; and the Vall d'Hebron and Bellvitge university hospitals, in Barcelona.