Background

Hypogammaglobulinemia (HGG) is a complication of solid organ transplantation leading to increased risk of infections. Intravenous immunoglobulin G (IVIG) replacement in patients with HGG may be able to reduce risk and morbidity associated with infection; however, there is scarce data about IVIG in mild to moderate HGG (IgG 400–700 mg/dL) and heart transplant recipients.

Methods

A single center, retrospective study was performed in heart transplant recipients with mild (IgG 500–700 mg/dL) to moderate (IgG 400–499 mg/dL) HGG in the presence of an infection.

Results

Forty-two patients were included in this study; 19 patients (45.2%) received IVIG and 23 (54.8%) patients did not. Patients in the IVIG group received on average one dose of IVIG at 0.5 g/kg. No differences in incidence of new infection at 3 months (26.3% vs 17.4%; p = 0.71) and 6 months (42.1% vs 34.8%; p = 0.63) were observed between the IVIG and non-IVIG groups. Infections based on mild or moderate HGG also had no differences at 3 and 6 months.

Conclusion

Our findings suggest that a single infusion of IVIG in mild to moderate HGG may have little to no benefit in reducing incidence of new infections. Larger prospective studies are needed to confirm these findings.

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