Transfusion Medicine Reviews
Volume 24, Supplement 1 , Pages S7-S27, January 2010

The Use of Immunoglobulin Therapy for Patients Undergoing Solid Organ Transplantation: An Evidence-Based Practice Guideline

Department of Medicine, University of Toronto, St. Michael's Hospital, Canadian Blood Services, Toronto, Ontario, Canada

Departments of Medicine and Health Policy Evaluation, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada

National Cancer Institute of Canada Clinical Trials Group and Departments of Oncology, Medicine and Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada

Department of Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada

Department of Medicine, University of Manitoba, Canadian Blood Services, Winnipeg, Manitoba, Canada

Division of Pediatric Nephrology, Children's Hospital, Winnipeg, Manitoba, Canada

Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

Department of Medicine, University of Toronto, University Health Network, Toronto, Ontario, Canada

Department of Pediatrics, Université de Montréal, Hôpital Ste Justine, Montreal, Quebec, Canada

Department of Surgery, University of Toronto, University Health Network, Toronto, Ontario, Canada

Li Ka Shing Knowledge Institute, Canada

Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

Departments of Medicine, Community Health and Epidemiology and Pathology Dalhousie University, Halifax, Nova Scotia, Canada

Canadian Blood Services, Ottawa, Ontario, Hôpital Sainte Justine, Montreal, Quebec, Canada

This guideline for the use of immunoglobulin (IG) for sensitized patients undergoing solid organ transplantation (SOT) is an initiative of the Canadian Blood Services and the National Advisory Committee on Blood and Blood Products of Canada to (1) provide guidance for Canadian practitioners involved in the care of patients undergoing SOT and transfusion medicine specialists on the use of IG and (2) standardize care, limit adverse events, and optimize patient care. A systematic expert and bibliography literature search up to July 2008 was conducted, with 791 literature citations and 45 reports reviewed. To validate the recommendations, the guideline was sent to physicians involved in SOT in Canada and a patient representative. The recommendations identify (1) sensitized patients undergoing SOT that would have a better survival and decreased morbidity by receiving IG preoperatively, postoperatively, and for the treatment of organ rejection; (2) patients who may not have any benefit from receiving IG; and (3) potential adversities to IG.

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 STATEMENT OF CONFLICT OF INTEREST: Dr L West receives research funding from the US National Institutes of Health (Grant P01-HL079067). Drs Nadine Shehata and Peter Nickerson are employees of Canadian Blood Services, as were Drs Heather Hume and John Freedman during the period of the development of these guidelines. Funding was provided from an unrestricted education grant from Bayer, Inc, to Canadian Blood Services. Bayer did not have any role in the selection of panel members, the literature search, the selection of articles, or the development of the recommendations.

PII: S0887-7963(09)00090-X

doi:10.1016/j.tmrv.2009.09.010

Transfusion Medicine Reviews
Volume 24, Supplement 1 , Pages S7-S27, January 2010

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