Abstract
Due to growing incidence of severe infections associated with secondary antibody deficiency (SAD), this risk factor is being explored as a potential new indication of intravenous immunoglobulin (IVIG) in settings such as solid organ transplantation, post-rituximab use in autoimmune diseases and after therapy of B-cell lymphomas. The clinical criteria for this IVIG indication is the presence of severe infections. The immunological criteria that is being explored by the European Medicines Agency is the presence of severe hypogammaglobulinemia (HGG: IgG below 400 mg/dL) with demonstration of failure to produce specific antibodies after vaccination. In the case of thoracic transplantation the majority of severe infections are concentrated during the first 6 months, a period in which vaccination is avoided in the majority of centers. Objective. To define the prevalence and components of severe SAD in thoracic transplantation.
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