Abstract
<h3>Purpose</h3> Infections are common and feared in patients with left ventricular assist device (LVAD) support. As the infected components cannot easily explanted, therapy is often insufficient and patients require heart transplantation (HTx). However, immunosuppression can aggravate the present infective complications. IgM-enriched intravenous human immunoglobulin (IGM-IVIG) conveys multiple anti-infective effects and may serve as an adjuvant therapy in these patients. <h3>Methods</h3> Between January and August 2021 a total of n=35 patients underwent HTx in our department. Of those, n=4 patients (p1-4) had a present infection of a left ventricular assist device. Immediately after HTx, laboratory parameters including immunoglobulins were evaluated and patients received 3 ml/kg body weight IGM-IVIG (Pentaglobin®, Biotest AG, Dreieich, Germany). IGM-IVIG application was repeated with 5 mg/kg body weight per day if immunoglobulins were below the reference range. Immunosuppression consisted of tacrolimus, mycophenolate mofetil and prednisolone. <h3>Results</h3> While P1, 2 and 4 suffered from driveline infection due caused by Pseudomonas aeruginosa or Staphylococcus aureus, P3 suffered from pericardial abscess close to the device, however microbiology could not identify germs. All patients were treated with antibiotics and had sufficient immunoglobulin concentrations before and after the IgM-IVIG application. Therefore, every patient only received IgM-IVIG once directly postoperative. While in P2-4 a raise in immunoglobulin concentration was observed after IgM-IVIG (mean increase of IgG=232 mg/dl (29 %), IgA=28 mg/dl (14 %), IgM=21 mg/dl (36 %), concentration in P1 dropped by about 40 %. This was most likely associated with severe bleeding complications of the patient. None of the patient suffered from postoperative infective complications or therapy-related adverse events. <h3>Conclusion</h3> Adjuvant application of IgM-IVIG is safe and feasible in patients undergoing HTx after LVAD infection. Although our results cover only a small proportion of patients, we were able to report adequate immunoglobulin concentrations and sufficient postoperative immune response in every patient.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
