ORBCoN Immune Globulin Resources – 2024 Update

Donna Berta, ORBCoN, Clinical Project Coordinator Nursing

Immune Globulin (IG), both intravenous (IVIG) and subcutaneous (SCIG), is an extensively used blood product. To fulfill the Ontario Regional Blood Coordinating Network’s (ORBCoN) mission, “inspiring and facilitating best transfusion practices in Ontario”¹a wealth of IG resources are available on the ORBCoN website.

The IG landing page was introduced to streamline and simplify navigating ORBCoN’s website. From the ORBCoN website, https://transfusionontario.org/en/, select the Resources tab, and then click the heading “IVIG/SCIG” to explore the landing page (refer to Figure 1).

Figure 1: ORBCoN Website: IVIG/SCIG Landing Page

The landing page identifies each of ORBCoN’s IG resources on a card. A synopsis and time stamp of each of these IG resources is presented (refer to Table 1).

Table 1: Description of ORBCoN’s IG Resources

Resources specific to SCIG are structured within the ORBCoN Home Infusion Toolkit. This toolkit outlines the requirements for hospitals that issue home infusion products to patients. Example documents to support and manage such programs are also provided.

ORBCoN has developed IG resources to assist hospital Transfusion Medicine laboratories and health care providers to treat patients following best practice, evidence-based standards. The Utilization Management Guidelines (as well as Ordering IG in Ontario, which is informed by the Utilization Management Guidelines) are currently being evaluated for additional evidence-based information. To learn more about the newest resource, the IG Quality Improvement Project (IG QIP), refer to that article in this March 2024 Newsletter.

Feedback regarding these resources or suggestions for alternate resources that would be of benefit is most appreciated. Reach out to your regional ORBCoN office (contact details found at https://transfusionontario.org/en/contact/).

References

Ontario Regional Blood Coordinating Network. About us [Internet]. Toronto ON; Ontario Regional Blood Coordinating Network; 2006 [revised 2020 cited 2024 Jan 23]. Available from: https://transfusionontario.org/en/about/
Ontario Regional Blood Coordinating Network. IVIG/SCIG [Internet]. Toronto ON; Ontario Regional Blood Coordinating Network; 2023 Dec [cited 2024 Jan 23]. Available from: https://transfusionontario.org/en/category/ivig-scig/
Ontario Regional Blood Coordinating Network. Home Infusion Toolkit [Internet]. Toronto ON; Ontario Regional Blood Coordinating Network; 2019 Dec [cited 2024 Jan 23]. Available from: https://transfusionontario.org/en/category/toolkits/home-infusion-toolkit/

Upcoming Events

CSTM 2024

Transfusionists Talk

19th Annual Transfusion Medicine Education Web Symposium

U of T

March 28, 2024 @12pm-1pm

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« Ministry of Health / ORBCoN Immune Globulin Quality Improvement Project

ONIT Program Update »

	One page summary regarding using the MOHLTC IG Request Form. Ontario MOHLTC IG Request Form Neurology and Ontario MOHLTC IG Request Form Non-Neurology (including fillable formats). Version January 31, 2018.
	Recommended IG indications (with additional information) as well as dose and frequency of administration are listed by clinical service. Some indications where IG is not recommended for routine use are also detailed. Seven IG utilization strategies for all hospitals where IG is prescribed. Version January 31, 2018
	The patient’s sex, height, and weight are entered to calculate: Ideal body weight and dosing weight IVIG dose (select dose) and rounded dose Body mass index (BMI). A mobile app is available with these calculations as well as the recommended IG indications information. Version January 31, 2018
	Centralized repository for IG utilization data to endorse continuous audit and feedback for IG stewardship (voluntary participation). Includes protocol, user guide, tracking log, survey for registration to participate link, and REDCap repository log on link. Version September 2023 MOH/ORBCoN IVIG audit reports 2012 and 2015.
	Incorporates six resources in one document: Ordering IG in Ontario, Utilization Management Guidelines, Dosing Using Adjusted Body Weight, Facts for Patients, Travelling with IG and Infusion Guide and Adverse Events. Version January 31, 2018
	Downloadable and print ready IG information (what, why, how, risks, and side effects) for outpatients who are being treated with IVIG. Version October 31, 2015 This resource is being revised; an updated version is anticipated April 2024.
	Information regarding receiving infusion of IVIG outside of Ontario, with IVIG supplied by an Ontario hospital (participation agreement/ patient responsibilities, letter from treating physician to travel destination health care prescriber, and IVIG travel letter for the patient regarding their IVIG vials and ancillary supplies). Version January 2018
	Reviews general practices when administering IVIG (pre, during, and post infusion), infusion rate increment tables (IVIG brand specific, adults, five-kilogram weight range categories), and an adverse reaction chart listing signs and symptoms, possible etiology, as well as suggested treatment/actions and strategies to mitigate. Version March 10, 2022