التفاصيل البيبلوغرافية
| العنوان: |
Detrimental Association of Hypogammaglobulinemia With Chronic Lung Allograft Dysfunction and Death Is Not Mitigated by On-Demand Immunoglobulin G Replacement After Lung Transplantation. |
| المؤلفون: |
Lichvar, Alicia B., Ensor, Christopher R., Zeevi, Adriana, Morrell, Matthew R., Pilewski, Joseph M., Hayanga, J. W. Awori, D'Cunha, Jonathan, McDyer, John F., Petrov, Andrej A. |
| المصدر: |
Progress in Transplantation; Mar2019, Vol. 29 Issue 1, p18-25, 8p |
| مصطلحات موضوعية: |
THERAPEUTIC use of immunoglobulins, INFECTION risk factors, TACROLIMUS, AGAMMAGLOBULINEMIA, MYCOPHENOLIC acid, ANALYSIS of variance, CHI-squared test, COMMUNICABLE diseases, CONFIDENCE intervals, DEATH, GRAFT rejection, IMMUNOGLOBULINS, LONGITUDINAL method, OBSTRUCTIVE lung diseases, LUNG transplantation, MULTIVARIATE analysis, PNEUMONIA, RESEARCH funding, STATISTICS, T-test (Statistics), TRANSPLANTATION of organs, tissues, etc., PROPORTIONAL hazards models, RETROSPECTIVE studies, DATA analysis software, DESCRIPTIVE statistics, KAPLAN-Meier estimator, LOG-rank test, ODDS ratio, MANN Whitney U Test, KRUSKAL-Wallis Test, THERAPEUTICS |
| مستخلص: |
Background: 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. Materials and Methods: 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. Results: 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). Conclusions: 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. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
