: Background: Infections frequently occur after orthotopic liver transplantation (OLT) and are associated with increased mortality. In 2018, we introduced perioperative administration of intravenous immunoglobulin enriched in IgM as an optional therapy in recipients at a high risk of infection. This preliminary study evaluated whether this preparation reduced infections in the early post-transplantation period. Methods: Adult patients with a high risk of postoperative infections who underwent OLT between January 2014 and December 2021 in our center were included in the study. The primary outcome was the occurrence of new postoperative bacterial and fungal infections within the first 30 days after OLT. Results: Ninety recipients at a high risk of postoperative infections who underwent OLT were included, of whom 51 (57%) received IgM preparation. Patients treated and not treated with IgM were similar in terms of demographics, model of end-stage liver disease score, and risk factors for postoperative infections. The occurrence of new infections was lower (absolute risk reduction (ARR) 21.2%; p = 0.038) in patients who received IgM than in those who did not. Multivariate analysis adjusted for confounders (OR 0.348; p = 0.033) and propensity score-based matching analysis (ARR 21.2%, p = 0.067) confirmed an association between IgM preparation and lower occurrence of postoperative infections. The 90-day mortality rate was lower (ARR 13.4%, p = 0.018) in patients who received IgM preparation. Conclusions: In OLT recipients at high risk for infections, perioperative administration of an IgM-enriched preparation seems to reduce the development of new infections within the first 30 days after OLT.

Perioperative Use of IgM-Enriched Immunoglobulins in Liver Transplantation Recipients at High Risk for Infections: A Preliminary Study / Roat, Erika; Tosi, Martina; Coloretti, Irene; Bondi, Filippo; Chierego, Giovanni; De Julis, Stefano; Talamonti, Marta; Biagioni, Emanuela; Busani, Stefano; Di Sandro, Stefano; Franceschini, Erika; Guerrini, Gian Piero; Meschiari, Marianna; Di Benedetto, Fabrizio; Mussini, Cristina; Girardis, Massimo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:16(2024), pp. 1-10. [10.3390/jcm13164965]

Perioperative Use of IgM-Enriched Immunoglobulins in Liver Transplantation Recipients at High Risk for Infections: A Preliminary Study

Roat, Erika;Tosi, Martina;Coloretti, Irene;Bondi, Filippo;De Julis, Stefano;Talamonti, Marta;Biagioni, Emanuela;Busani, Stefano;Di Sandro, Stefano;Guerrini, Gian Piero;Meschiari, Marianna;Di Benedetto, Fabrizio;Mussini, Cristina;Girardis, Massimo
2024

Abstract

: Background: Infections frequently occur after orthotopic liver transplantation (OLT) and are associated with increased mortality. In 2018, we introduced perioperative administration of intravenous immunoglobulin enriched in IgM as an optional therapy in recipients at a high risk of infection. This preliminary study evaluated whether this preparation reduced infections in the early post-transplantation period. Methods: Adult patients with a high risk of postoperative infections who underwent OLT between January 2014 and December 2021 in our center were included in the study. The primary outcome was the occurrence of new postoperative bacterial and fungal infections within the first 30 days after OLT. Results: Ninety recipients at a high risk of postoperative infections who underwent OLT were included, of whom 51 (57%) received IgM preparation. Patients treated and not treated with IgM were similar in terms of demographics, model of end-stage liver disease score, and risk factors for postoperative infections. The occurrence of new infections was lower (absolute risk reduction (ARR) 21.2%; p = 0.038) in patients who received IgM than in those who did not. Multivariate analysis adjusted for confounders (OR 0.348; p = 0.033) and propensity score-based matching analysis (ARR 21.2%, p = 0.067) confirmed an association between IgM preparation and lower occurrence of postoperative infections. The 90-day mortality rate was lower (ARR 13.4%, p = 0.018) in patients who received IgM preparation. Conclusions: In OLT recipients at high risk for infections, perioperative administration of an IgM-enriched preparation seems to reduce the development of new infections within the first 30 days after OLT.
2024
13
16
1
10
Perioperative Use of IgM-Enriched Immunoglobulins in Liver Transplantation Recipients at High Risk for Infections: A Preliminary Study / Roat, Erika; Tosi, Martina; Coloretti, Irene; Bondi, Filippo; Chierego, Giovanni; De Julis, Stefano; Talamonti, Marta; Biagioni, Emanuela; Busani, Stefano; Di Sandro, Stefano; Franceschini, Erika; Guerrini, Gian Piero; Meschiari, Marianna; Di Benedetto, Fabrizio; Mussini, Cristina; Girardis, Massimo. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:16(2024), pp. 1-10. [10.3390/jcm13164965]
Roat, Erika; Tosi, Martina; Coloretti, Irene; Bondi, Filippo; Chierego, Giovanni; De Julis, Stefano; Talamonti, Marta; Biagioni, Emanuela; Busani, Ste...espandi
File in questo prodotto:
File Dimensione Formato  
RoatIgJCM24.pdf

Open access

Tipologia: Versione pubblicata dall'editore
Dimensione 437.43 kB
Formato Adobe PDF
437.43 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1353586
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact