Previous studies have shown a benefit of
intravenous immunoglobulin infusions for the prophylaxis of primary CMV
infections in renal transplant recipients. This study was undertaken in order to see if high-risk renal transplant patients at risk for secondary CMV
infection would benefit from prophylactic
intravenous immunoglobulin infusions. A randomized prospective study of renal transplant recipients who were considered at high risk for secondary CMV
infection was performed. Thirty-four patients were studied, 16 receiving the
intravenous immunoglobulin infusions and 18 being untreated controls. Unselected lots of
Sandoglobulin (Sandoz) were used for the treatment group (500 mg/kg x 3 doses, followed by 250 mg/kg x 2 doses at 2-week intervals). The number of days febrile and days hospitalized secondary to CMV illness, and the number of complications secondary to CMV illness, were significantly reduced in the patients who were prophylactically treated with
intravenous immunoglobulin infusions. None of the patients died from CMV
infection in either group. There were no significant complications related to the
intravenous immunoglobulin infusions. This study suggests that prophylactic
immunoglobulin infusions will reduce the severity of CMV
infection in the patient who is at risk for secondary or
reactivation infection as well as the patient at risk for primary
infection. This
therapy should be considered for renal transplant recipients who are at high risk for developing CMV
infection, both primary and secondary.