Persistent hypogammaglobulinemia in pediatric solid organ transplant recipients
Corresponding Author
Rebecca Pellett Madan
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Department of Pediatrics, New York University Grossman School of Medicine and Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA
Correspondence
Rebecca Pellett Madan, Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, New York, 19916, USA
Email: [email protected]
Search for more papers by this authorRhiannon R. Penkert
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorSherri L. Surman
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorBart G. Jones
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorJames Houston
Department of Neurology, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorJacqueline M. Lamour
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorMarcela Del Rio
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorBetsy C. Herold
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorJulia L. Hurwitz
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorCorresponding Author
Rebecca Pellett Madan
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Department of Pediatrics, New York University Grossman School of Medicine and Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA
Correspondence
Rebecca Pellett Madan, Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, New York, 19916, USA
Email: [email protected]
Search for more papers by this authorRhiannon R. Penkert
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorSherri L. Surman
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorBart G. Jones
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorJames Houston
Department of Neurology, St. Jude Children’s Research Hospital, Memphis, TN, USA
Search for more papers by this authorJacqueline M. Lamour
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorMarcela Del Rio
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorBetsy C. Herold
Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
Search for more papers by this authorJulia L. Hurwitz
Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA
Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorAbstract
Introduction
Hypogammaglobulinemia has not been well studied in pediatric solid organ transplant (SOT) recipients. We evaluated plasma immunoglobulin (Ig) and lymphocyte phenotypes among 31 pediatric heart and kidney recipients for two years post-transplant and from 10 non-transplanted children.
Methods
Plasma IgM, IgG, and IgA were quantified by immunoturbidimetric assays, IgG subclasses were quantified by bead-based multiplex immunoassay, and lymphocyte phenotypes were assessed by flow cytometry.
Results
Median age at transplant for SOT recipients was similar to that of the control cohort (15 vs. 12.5 years, respectively; P = .61). Mean plasma IgG and IgM levels for SOT recipients fell significantly below the control cohort means by 1 month post-transplant (P < .001 for both) and remained lower than control levels at 12-18 months post-transplant. Heart recipients had lower frequencies of a CD4+ naïve T lymphocytes relative to kidney recipients.
Conclusions
Hypogammaglobulinemia was prevalent and persistent among pediatric SOT recipients and may be secondary to immunosuppressive medications, as well as loss of thymus tissue and CD45RA+ CD4+ T cells in heart recipients. Limitations of our study include but are not limited to small sample size from a single center, lack of samples for all participants at every time point, and lack of peripheral blood mononuclear cell samples for the non-transplanted cohort.
Supporting Information
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| ctr14021-sup-0001-FigS1.pdfPDF document, 87.9 KB | Supplementary Material |
| ctr14021-sup-0002-TableS1-4.docxWord document, 43.8 KB | Supplementary Material |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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