11. The Use of Immune Globulin Intravenous, Human-slra 10% Therapy in Lung Transplant Recipients

Background: In lung transplant patients, immunoglobulin replacement therapy significantly decreases the incidence and severity of infections in those with hypogammaglobulinemia. Lung transplantation has certain complications, such as allograft rejection and infections. Immunoglobulin replacement therapy is a biological agent made from human antibodies, used to manage various immunodeficiency and inflammatory conditions.

Purpose: Can the use of the study IG product when administered to lung transplant recipients prevent respiratory syncytial virus in this patient population? .In lung transplant patients, immunoglobulin replacement therapy significantly decreases the incidence and severity of infections in those with hypogammaglobulinemia. Our hypothesis is that due to the unique composition of the study IG product patients post lung transplant may have a reduced incidence of RSV.

Methods: The goal of this retrospective study is to determine the effect of IVIG, human-slra in improving patient’s lung function, preventing infections, and exercise capacity. To achieve this goal, the medical records of 7 lung transplant patients were analyzed for FEV1, FVC and exercise capacity. Six patients received a single lung transplant and one had a double lung transplant. Of note, one patient required a repeat transplant due to chronic lung allograft dysfunction prior to initiation of the study). Patient electronic records were used to data collection.

Results: All patients tolerated IVIG, human-slra without any reported adverse events. Five of the seven patients were alive upon analysis. Two patients had compromised post-operative lung status and expired; both patients participated in a pulmonary rehabilitation program, one of which was oxygen dependent with decreased oxygen saturation with exercise. All patients were using antibiotics for infection prophylaxis. No patients had respiratory syncytial viruses reported post-transplant.

Of the surviving patients, 80% (four of the five surviving patients) presented as eupneic with normal lung sounds. Three patients acquired COVID post-operatively. One required hospitalization during their course of illness. One patient experienced five hospitalizations following transplant, however all were unrelated to their lung status. FEV1 and FVC results showed improvement in three of the five surviving patients. All surviving patients were able to regain the ability to exercise in varying degrees. Four of the five surviving patients were able to walk significantly outdoors and climb stairs.

Discussion: IVIG, human-slra has been used successfully in the study patients in conjunction with immunosuppressive agents and prophylactic antibiotics and antivirals. Restoration of lung function due to respiratory stability was present in 80% of the surviving patients evaluated.

Conclusions: IVIG, human-slra’s unique antibody composition could have played a role in the effective management of patients’ post-lung transplant. Improvement in overall lung function was noted with 80% of the surviving study patients presenting as eupneic with clear lungs and all surviving patients regaining the ability to exercise to varying degrees.