{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T08:36:02Z","timestamp":1772699762463,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30\u00a0days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti\u2010PPS) determined using enzyme\u2010linked immunosorbent assay. The clinical follow\u2010up period lasted 6\u00a0months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At day 7, IgG hypogammaglobulinemia (IgG levels\u00a0&lt;\u00a0700\u00a0mg\/dL) combined with low IgG anti\u2010CMV antibody titers (defined as levels\u00a0&lt;\u00a010\u00a0000 units) was present in 12% of kidney recipients. IgG hypogammaglobulinemia combined with low IgG anti\u2010PPS antibody titers (defined as levels\u00a0&lt;\u00a010\u00a0mg\/dL) at 1\u00a0month after kidney transplantation were recorded in 16% of patients. At day 7 the combination of IgG hypogammaglobulinemia and low anti\u2010CMV titers was independently associated with the development of CMV disease (odds ratio [OR], 6.95; 95% confidence interval [CI], 1.17\u201041.31; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.033). At day 30 after transplantation, the combination of IgG\u00a0&lt;\u00a0700\u00a0mg\/dL and IgG anti\u2010PPS\u00a0&lt;\u00a010\u00a0mg\/dL, was independently associated with recurrent bacterial infection (OR, 5.942; 95% CI, 1.943\u201018.172; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a prospective multicenter study, early immunologic monitoring of secondary antibody deficiency proved useful for the identification of kidney recipients who developed severe infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13494","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T19:24:45Z","timestamp":1602876285000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study"],"prefix":"10.1111","volume":"23","author":[{"given":"Elizabeth","family":"Sarmiento","sequence":"first","affiliation":[{"name":"Clinical Immunology Department Hospital General Universitario Gregorio Mara\u00f1on Madrid Spain"},{"name":"Immunology Department Universidad Complutense Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maricela","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department Hospital General Universitario Gregorio Mara\u00f1on Madrid Spain"},{"name":"Immunology Department Universidad Complutense Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"di Natale","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department Hospital General Universitario Gregorio Mara\u00f1on Madrid Spain"},{"name":"Immunology Department Universidad Complutense Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"Rodriguez\u2010Ferrero","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital General Universitario Gregorio Mara\u00f1on Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Anaya","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital General Universitario Gregorio Mara\u00f1on Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos","family":"Lopez\u2010Hoyos","sequence":"additional","affiliation":[{"name":"Immunology Department Hospital Universitario Marqu\u00e9s de Valdecilla\u2010IDIVAL Santander Spain"},{"name":"Histocompatibility Testing Laboratory Hospital 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