Nephrology
IVIG is a form of immunoglobin made from blood plasma. Given to patients via injection, IVIG therapy reduces HLA sensitivity by adding helpful antibodies to the bloodstream. This lowers the level of HLA antibodies and blocks their ability to attack a transplanted organ.
Heart: Antibody-mediated graft rejection caused by donor-specific antibodies (DSA-MR) remains a serious problem after heart transplantation (HTx). IgM-enriched human intravenous immunoglobulin (IGM-IVIG) consists of 76% IgG, 12% IgM, and 12% IgA and provides a new multifactorial approach for DSA-MR.
Lung: In Lung Transplant, IVIG monotherapy is associated with significant reduction in de novo DSA. DSA clearance may result in less acute rejection. Randomized controlled trials are needed to determine the optimal strategy for managing de novo DSA.
Nephrology: Interestingly, high-dose IVIG has been successfully utilized for the suppression of panel reactive antibodies in the management of highly sensitized patients with late-stage CKD receiving dialysis while awaiting kidney transplantation.
Definitions of Acronyms:
De novo DSA: Defined as new DSA detected by single antigen bead technology and/or a donor-specific flow crossmatch that was negative pretransplant and positive at the time of biopsy.
AMR: Antibody Mediated Rejection
CKD: Chronic Kidney Disease
DSA: Donor-Specific Alloantibody