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 Detalle_Publicacion

Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study

Abstract: Background: We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation. Methods: We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30 days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti-PPS) determined using enzyme-linked immunosorbent assay. The clinical follow-up period lasted 6 months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression. Results: At day 7, IgG hypogammaglobulinemia (IgG levels < 700 mg/dL) combined with low IgG anti-CMV antibody titers (defined as levels < 10 000 units) was present in 12% of kidney recipients. IgG hypogammaglobulinemia combined with low IgG anti-PPS antibody titers (defined as levels < 10 mg/dL) at 1 month after kidney transplantation were recorded in 16% of patients. At day 7 the combination of IgG hypogammaglobulinemia and low anti-CMV titers was independently associated with the development of CMV disease (odds ratio [OR], 6.95; 95% confidence interval [CI], 1.17-41.31; P = .033). At day 30 after transplantation, the combination of IgG < 700 mg/dL and IgG anti-PPS < 10 mg/dL, was independently associated with recurrent bacterial infection (OR, 5.942; 95% CI, 1.943-18.172; P = .002). Conclusion: In a prospective multicenter study, early immunologic monitoring of secondary antibody deficiency proved useful for the identification of kidney recipients who developed severe infection.

 Fuente: Transpl Infect Dis. 2020;00:e13494.

Editorial: Wiley

 Fecha de publicación: 10/10/2020

Nº de páginas: 13

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/tid.13494

ISSN: 1398-2273,1399-3062

Url de la publicación: https://doi.org/10.1111/tid.13494

Autores/as

SARMIENTO, ELIZABETH

JIMENEZ, MARICELA

DI NATALE, MARISA

RODRIGUEZ FERRERO, MARISA

ANAYA, FERNANDO

MANUEL ANTONIO ARIAS RODRIGUEZ

PERELLO, MANEL

SERON, DANIEL

KARANOVIC, BORIS

EZZAHOURI, IKRAM

MEZZANO, SERGIO

JARAMILLO, MARIA

CALAHORRA, LETICIA

ALARCON, ALBA

NAVARRO, JOAQUIN

MUÑOZ, PATRICIA

CARBONE, JAVIER