ArticleClinical journal of the American Society of Nephrology : CJASN2009
Acute hemolysis after high-dose intravenous immunoglobulin therapy in highly HLA sensitized patients.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02123615 (ASIS for GAMMAGARD in Primary Immunodeficiency), which is not on this map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
ASIS for GAMMAGARD in Primary Immunodeficiency
Who cites it
25 citing papers in PubMed, 126 citations in OpenAlex.
- Intravenous immunoglobulin treatment in childhood encephalitis (IgNiTE): a randomised controlled trial.BMJ open · 2023Trial
- New perspectives on fetal and neonatal alloimmune thrombocytopenia for obstetricians.Frontiers in immunology · 2026Review
- Expert consensus recommendations for the prevention and management of immunoglobulin therapy-related adverse reactions in primary and secondary immunodeficiencies: a national Delphi study from the Immunodeficiency Group of the Spanish Society of Immunology.Frontiers in immunology · 2026Article
- Characteristics of adverse events and clinical risks of intravenous immunoglobulin: a pharmacovigilance study based on FDA Adverse Event Reporting System (FAERS).Frontiers in medicine · 2025Article
- Current protocols and outcomes of ABO-incompatible kidney transplantation.World journal of transplantation · 2020Review
- Treatment-associated hemolysis in Kawasaki disease: association with blood-group antibody titers in IVIG products.Blood advances · 2020Article
- Anti-A/B isoagglutinin reduction in an intravenous immunoglobulin product and risk of hemolytic anemia: a hospital-based cohort study.Transfusion · 2020Article
- Article
- Factors associated with anaemia in kidney transplant recipients in the first year after transplantation: a cross-sectional study.BMC nephrology · 2018Article
- Laboratory Markers in Incomplete Kawasaki Disease according to Coronary Artery Outcome.Korean circulation journal · 2018Article
- Reduction of Isoagglutinin in Intravenous Immunoglobulin (IVIG) Using Blood Group A- and B-Specific Immunoaffinity Chromatography: Industry-Scale Assessment.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2016Article
- Human immune globulin infusion in the management of multifocal motor neuropathy.Degenerative neurological and neuromuscular disease · 2016Review
- ABO-incompatible living donor kidney transplantation without post-transplant therapeutic plasma exchange.Journal of clinical apheresis · 2015Article
- Pathogenesis and mechanisms of antibody-mediated hemolysis.Transfusion · 2015Review
- On the dark side of therapies with immunoglobulin concentrates: the adverse events.Frontiers in immunology · 2015Review
- Isoagglutinin Reduction in Human Immunoglobulin Products by Donor Screening.Biologics in therapy · 2014Article
- Occurrence of hemolytic anemia in patients with GBS treated with high-dose IVIg.Neurology(R) neuroimmunology & neuroinflammation · 2014Article
- American Society of Nephrology Quiz and Questionnaire 2013: transplantation.Clinical journal of the American Society of Nephrology : CJASN · 2014Article
- Acute Antibody-Mediated Rejection in Renal Transplantation: Current Clinical Management.Current transplantation reports · 2014Article
- ABO incompatible renal transplants: Good or bad?World journal of transplantation · 2014Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesIntravenous Ig (IVIG) is used in renal transplantation for desensitization and treatment of antibody-mediated rejection (AMR). The infusion of high-dose IVIG is generally well tolerated, but there are reports of hemolytic anemia induced by anti-blood group antibodies present in IVIG. Here, we report our experience with IVIG-induced hemolytic anemia (IH) in ESRD patients receiving IVIG for desensitization or treatment of AMR. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All patients receiving IVIG for desensitization or for treatment of AMR were monitored for evidence of acute anemia and hemolysis. Markers of hemolysis, including direct antiglobulin tests, were recorded. Five different IVIG products were tested for isohemagglutinin titers.
resultsThere were 18 cases of IH in 16 patients. All identified cases received the IVIG product Gamunex, Gammagard liquid, or Privigen. All patients developing hemolysis were non-O blood types. Isohemagglutinin titers ranged from 1:2 to 1:64 in the various IVIG products, with higher titers noted in the liquid, nonlyophilized products.
conclusionsAcute IH is a significant complication of high-dose IVIG infusion. Identified risk factors include non-O blood type of the recipient and administration of liquid IVIG preparations with high titer anti-A/B IgG antibodies. We recommend monitoring hemoglobin 48 to 72 h after IVIG infusion. If the hemoglobin decreases, a hemolytic work-up is recommended. Hemolysis could be avoided in at risk patients by choosing a low titer product. However, other complications such as acute renal failure or thrombosis may be seen because the low titer products are usually hyperosmotic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.