Document Detail

Decreased levels of serum complement C3 and natural killer cells add to the predictive value of total immunoglobulin G for severe infection in heart transplant recipients.
MedLine Citation:
PMID:  23013361     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Infection remains a source of mortality in heart recipients. We previously reported that post-transplant immunoglobulin G (IgG) quantification can help identify the risk for infection. We assessed whether other standardized parameters of humoral and cellular immunity could prove useful when identifying patients at risk of infection.
METHODS: We prospectively studied 133 heart recipients over a 12-month period. Forty-eight patients had at least one episode of severe infection. An event was defined as an infection requiring intravenous antimicrobial therapy.
RESULTS: Cox regression analysis revealed an association between the risk of developing infection and the following: lower IgG2 subclass levels (day 7: relative hazard [RH] 1.71; day 30: RH 1.76), lower IgA levels (day 7: RH 1.61; day 30: RH 1.91), lower complement C3 values (day 7: RH 1.25), lower CD3 absolute counts (day 30: RH 1.10), lower absolute natural killer [NK] cell count (day 7: RH 1.24), and lower IgG concentrations (day 7: RH 1.31; day 30: RH 1.36). Cox regression bivariate analysis revealed that lower day 7 C3 levels, IgG2 concentration, and absolute NK cell count remained significant after adjustment for total IgG levels.
CONCLUSIONS: Data suggest that early immune monitoring including C3, IgG2, and NK cell testing in addition to IgG concentrations is useful when attempting to identify the risk of infection in heart transplant recipients.
E Sarmiento; N Del Pozo; A Gallego; J Fernández-Yañez; J Palomo; A Villa; M Ruiz; P Muñoz; C Rodríguez; J Rodríguez-Molina; J Navarro; K Kotsch; E Fernandez-Cruz; J Carbone
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplant infectious disease : an official journal of the Transplantation Society     Volume:  14     ISSN:  1399-3062     ISO Abbreviation:  Transpl Infect Dis     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883688     Medline TA:  Transpl Infect Dis     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  526-39     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Clinical Immunology Department, University Hospital Gregorio Marañón, Madrid, Spain.
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