Abstract | BACKGROUND: METHODS: Periodic monitoring of the IgG levels was done in 300 heart transplant recipients. Moderate hypogammaglobulinemia ( IgG, 350-500 mg/dl) developed in 56 patients (18.6%). Thirty-three patients declined randomization but agreed to have their IgG levels monitored. Twenty-three patients were randomized to placebo (n = 10) or CytoGam (n = 13) at 105 +/- 63 days after transplantation. RESULTS: The baseline characteristics were similar. A significant reduction in CMV infection was noted in the CytoGam Group compared with the Placebo Group (15.4% [2/13] vs 60% [6/10], p = .039). Among patients who declined randomization, CMV infection developed in 13 (39.4%) of 33, and 6 (46.1%) of the 13 progressed to severe hypogammaglobulinemia. A trend for reduction in the average episodes of > or =grade 2 rejection during the 6-month period after randomization was noted in the CytoGam group (0.4 +/- 0.6 vs 1.4 +/- 1.3, p = 0.065). CONCLUSIONS: The preemptive use of CytoGam decreases the incidence of CMV infection in patients with moderate hypogammaglobulinemia. A larger randomized study is needed to substantiate these results.
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Authors | Mohamad H Yamani, Robin Avery, Steven D Mawhorter, Ann McNeill, Daniel Cook, Norman B Ratliff, David Pelegrin, Phyllis Colosimo, Karen Kiefer, Kristin Ludrosky, Robert Hobbs, David Taylor, Tiffany Buda, Michael Yeager, James B Young, Nicholas Smedira, Randall C Starling |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 24
Issue 11
Pg. 1766-9
(Nov 2005)
ISSN: 1557-3117 [Electronic] United States |
PMID | 16297779
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Immunoglobulins
- Immunoglobulins, Intravenous
- cytomegalovirus-specific hyperimmune globulin
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Topics |
- Adult
- Agammaglobulinemia
(drug therapy)
- Cardiomyopathy, Dilated
(surgery)
- Cytomegalovirus Infections
(prevention & control)
- Female
- Graft Rejection
(epidemiology)
- Heart Transplantation
(adverse effects)
- Humans
- Immunization, Passive
- Immunocompromised Host
- Immunoglobulins
(therapeutic use)
- Immunoglobulins, Intravenous
- Male
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