IVIG Replacement for Hypogammaglobulinemia in Lung Transplant Patients

Abstract

After lung transplant, infection is a leading contributor to morbidity and mortality, and hypogammaglobulinemia (HGG) may be an important risk factor for many of these infections. Some reports suggest that HGG not only increases the risk of various infections, but also worsens survival. The incidence of HGG has been shown to increase after lung transplant, and may be as high as 70%. In order to mitigate this risk, intravenous immunoglobulin G (IVIG) replacement for the treatment of HGG has been utilized. However, the safety and efficacy of this practice after lung transplant has not been well described. The aim of this article is to review the current literature evaluating the use of IVIG replacement in HGG after lung transplant. In addition, practical considerations of IVIG including administration, adverse effects, and cost will be discussed.