The Evolution of Hypogammaglobulinemia in Kidney Transplant Recipients and Its Associated Risk Factors

E. Jo¹, S. Min², A. Han³

¹Surgery, Seoul National University Hospital, Seoul, Korea, Republic of, ²Surgery, Seoul National University College of Medicine, Seoul, Kosovo, Republic of, ³Seoul National University College of Medicine, Seoul, Korea, Republic of

Meeting: 2022 American Transplant Congress

Abstract number: 1580

Keywords: Cytomeglovirus, Immunoglobulins (Ig), Infection, Kidney

Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes

Session Information

Session Name: Biomarkers: Clinical Outcomes

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Hypogammaglobulinemia (HGG) has been extensively studied to identify a biological marker for infection. According to Florescu et al. (2013), a meta-analysis of 18 clinical studies confirmed that the severe low levels of serum IgG level (IgG<400mg/dL) in kidney transplant patients showed increased bacterial, CMV, and fungal infections. The purpose of this study was to analyze the serial changes in serum immunoglobulin level in kidney transplant recipients and determine the risks factors for the evolution of hypogammaglobulinemia.

*Methods: A retrospective study of serum samples from 192 kidney transplant recipients from August 17, 2016, to December 12, 2019, was undertaken. All patients had serum samples attained from 4 different periods – T0, preoperative baseline; T1, Postoperative 2 week; T2, Postoperative 3month; and T3, Postoperative 1 year. All serum samples were analyzed for IgG immunoglobulin level using nephelometry. Hypogammaglobulinemia was defined as IgG level below 700mg/dL. Clinical data and other laboratory data were retrospective reviews of electronic medical records.

*Results: 48 patients (33.3%) developed HGG up to 1-year post kidney transplantation. 144 patients did not develop HGG. Baseline and transplant characteristics between the two groups were not statistically different. Patients who developed HGG also had significantly more accompanying low levels of other immunoglobulin levels such as IgA and IgM throughout all four periods (p=<0.001). Episodes of rejection rate and treatment were similar in both groups. Episodes of severe infection requiring hospitalization were not different between the two groups. . Compared to the kidney recipients that did not develop HGG, the HGG group showed increased incidences of CMV infection (n=12 vs. n=8 respectively; p=0.001). Additional subgroup analysis of CMV infected patients was undertaken. Risk factors associated with CMV infection were preop DSA, HGG at baseline, and HGG at T2.

*Conclusions: Compared to the kidney recipients that did not develop HGG, the HGG group showed increased incidences of CMV infection (p=0.001).

To cite this abstract in AMA style:

Jo E, Min S, Han A. The Evolution of Hypogammaglobulinemia in Kidney Transplant Recipients and Its Associated Risk Factors [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-evolution-of-hypogammaglobulinemia-in-kidney-transplant-recipients-and-its-associated-risk-factors/. Accessed May 18, 2025.

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