Because infection has been associated with the development of bronchiolitis obliterans syndrome (BOS), we hypothesized that post-transplant hypogammaglobulinemia would be associated with infection and BOS.Cross-sectional levels of serum immunoglobulins were measured on 2 occasions in our transplant cohort and models developed to explain serum immunoglobulin levels and BOS-free survival.A total of 139 patients (median age, 46.6 years) were evaluated at 47 months (range, 15-74 months) after transplant, and 87 were re-evaluated at 72 months (40-107 months). Of this cohort, 44\% were immunoglobulin (Ig) G deficient and levels remained stable across the study period, and 27\% were IgA deficient and levels fell slightly over time (p = 0.003). Both immunoglobulin classes were lower in patients with a history of invasive fungal infection, whereas IgA levels were lower in patients with a history of community-acquired respiratory viral infection. Low IgG was independently associated with shorter BOS-free survival (hazard ratio, 0.79; 95\% confidence interval, 0.71-0.88; p<0.001).Serum immunoglobulin deficiency is common after lung transplantation and is associated with community-acquired respiratory viral infection, invasive fungal infection, and BOS.
%0 Journal Article
%1 Chambers2013
%A Chambers, Daniel C.
%A Davies, Belinda
%A Mathews, Ann
%A Yerkovich, Stephanie T.
%A Hopkins, Peter M.
%D 2013
%J J Heart Lung Transplant
%K transplantation prophylaxis prevention
%N 1
%P 36--43
%R 10.1016/j.healun.2012.10.006
%T Bronchiolitis obliterans syndrome, hypogammaglobulinemia, and infectious complications of lung transplantation.
%U http://dx.doi.org/10.1016/j.healun.2012.10.006
%V 32
%X Because infection has been associated with the development of bronchiolitis obliterans syndrome (BOS), we hypothesized that post-transplant hypogammaglobulinemia would be associated with infection and BOS.Cross-sectional levels of serum immunoglobulins were measured on 2 occasions in our transplant cohort and models developed to explain serum immunoglobulin levels and BOS-free survival.A total of 139 patients (median age, 46.6 years) were evaluated at 47 months (range, 15-74 months) after transplant, and 87 were re-evaluated at 72 months (40-107 months). Of this cohort, 44\% were immunoglobulin (Ig) G deficient and levels remained stable across the study period, and 27\% were IgA deficient and levels fell slightly over time (p = 0.003). Both immunoglobulin classes were lower in patients with a history of invasive fungal infection, whereas IgA levels were lower in patients with a history of community-acquired respiratory viral infection. Low IgG was independently associated with shorter BOS-free survival (hazard ratio, 0.79; 95\% confidence interval, 0.71-0.88; p<0.001).Serum immunoglobulin deficiency is common after lung transplantation and is associated with community-acquired respiratory viral infection, invasive fungal infection, and BOS.
@article{Chambers2013,
abstract = {Because infection has been associated with the development of bronchiolitis obliterans syndrome (BOS), we hypothesized that post-transplant hypogammaglobulinemia would be associated with infection and BOS.Cross-sectional levels of serum immunoglobulins were measured on 2 occasions in our transplant cohort and models developed to explain serum immunoglobulin levels and BOS-free survival.A total of 139 patients (median age, 46.6 years) were evaluated at 47 months (range, 15-74 months) after transplant, and 87 were re-evaluated at 72 months (40-107 months). Of this cohort, 44\% were immunoglobulin (Ig) G deficient and levels remained stable across the study period, and 27\% were IgA deficient and levels fell slightly over time (p = 0.003). Both immunoglobulin classes were lower in patients with a history of invasive fungal infection, whereas IgA levels were lower in patients with a history of community-acquired respiratory viral infection. Low IgG was independently associated with shorter BOS-free survival (hazard ratio, 0.79; 95\% confidence interval, 0.71-0.88; p<0.001).Serum immunoglobulin deficiency is common after lung transplantation and is associated with community-acquired respiratory viral infection, invasive fungal infection, and BOS.},
added-at = {2013-04-05T02:53:41.000+0200},
author = {Chambers, Daniel C. and Davies, Belinda and Mathews, Ann and Yerkovich, Stephanie T. and Hopkins, Peter M.},
biburl = {https://www.bibsonomy.org/bibtex/26f47fa1db7d5ae8155afd1167690d304/aorchid},
doi = {10.1016/j.healun.2012.10.006},
file = {:ID_General/TransplantClinical/JHeartLungTransplant.32.36.pdf:PDF},
groups = {public},
institution = {School of Medicine, The University of Queensland, Queensland, Australia. daniel_chambers@health.qld.gov.au},
interhash = {66b5e2f0d01983c6dc0d08214892626f},
intrahash = {6f47fa1db7d5ae8155afd1167690d304},
journal = {J Heart Lung Transplant},
keywords = {transplantation prophylaxis prevention},
language = {eng},
medline-pst = {ppublish},
month = Jan,
number = 1,
pages = {36--43},
pii = {S1053-2498(12)01363-0},
pmid = {23260704},
timestamp = {2013-04-05T02:53:41.000+0200},
title = {Bronchiolitis obliterans syndrome, hypogammaglobulinemia, and infectious complications of lung transplantation.},
url = {http://dx.doi.org/10.1016/j.healun.2012.10.006},
username = {aorchid},
volume = 32,
year = 2013
}