{"id":12704,"date":"2025-01-27T14:20:31","date_gmt":"2025-01-27T19:20:31","guid":{"rendered":"https:\/\/transfusionontario.org\/?p=12704"},"modified":"2025-01-27T15:06:30","modified_gmt":"2025-01-27T20:06:30","slug":"solid-organ-transplant-active-antibody-mediated-rejection-prevention-and-management-igum","status":"publish","type":"post","link":"https:\/\/transfusionontario.org\/en\/solid-organ-transplant-active-antibody-mediated-rejection-prevention-and-management-igum\/","title":{"rendered":"Solid organ transplant, active antibody-mediated rejection (ABMR) prevention and management"},"content":{"rendered":"\n<h2 class=\"wp-block-heading has-text-color has-link-color has-medium-font-size wp-elements-8c2c274f80c427244f898c8cc142e57d\" style=\"color:#477d6c\"><strong>Recommended Indications in which IG can be used<\/strong><\/h2>\n\n\n\n<h3 class=\"wp-block-heading has-black-color has-text-color has-background has-link-color has-small-font-size wp-elements-4c0e3f255d00cdad10a383fcc02b08ad\" style=\"background-color:#a5cbbf\"><strong>Order Number: T3-ABMR<\/strong><span style=\"font-size: medium; font-weight: 400; white-space-collapse: collapse;\"><\/span><\/h3>\n\n\n\n<figure class=\"wp-block-table is-style-regular\"><table><tbody><tr><td><strong>Recommendations<\/strong><\/td><td><strong>Pre-transplant:<\/strong> IVIG is recommended when an antibody or antibodies might preclude transplantation (e.g., donor specific anti-human leukocyte antigen antibody or anti-blood group antibody). IG may be continued for up to 3 months post-transplant.<br><br><strong>Post-transplant:<\/strong> IG may be used to treat active ABMR when other therapies are ineffective.<\/td><\/tr><tr><td><strong>Dose\/Frequency of Administration<\/strong><\/td><td><strong>IVIG with plasma exchange:<\/strong> 0.1 g\/kg adjusted body weight after each plasma exchange, to a maximum total dose of 2 g\/kg.<br><br><strong>IVIG alone:<\/strong> 2 g\/kg adjusted body weight divided over 2 to 5 days. When IVIG is used alone, further doses may be indicated every 4 weeks for a further three cycles, depending on clinical response or biopsy findings.<br><br>Thereafter, additional treatment cycles (often together with other treatment modalities) may be indicated, but only when biopsy findings and\/or clinical response demonstrate ongoing\/recurrent active ABMR or chronic active ABMR. Demonstration of ongoing\/recurrent active ABMR or chronic active ABMR should precede each treatment cycle.<br><br><strong>Note:<\/strong> Some sucrose-stabilized formulations of IVIG have shown nephrotoxicity and are best avoided in patients with pre-existing kidney impairment. Some nephrologists recommend that IVIG infusions be capped at 140 g\/day to reduce the risk of nephrotoxicity.<span style=\"font-size: medium; white-space-collapse: collapse;\"><\/span><\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Recommended Indications in which IG can be used<\/p>\n<p>Order Number: T3-ABMR<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_tec_requires_first_save":true,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false,"_tribe_blocks_recurrence_rules":"","_tribe_blocks_recurrence_description":"","_tribe_blocks_recurrence_exclusions":"","footnotes":""},"categories":[400],"tags":[],"class_list":["post-12704","post","type-post","status-publish","format-standard","hentry","category-transplant-indications"],"acf":[],"_links":{"self":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/posts\/12704","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/comments?post=12704"}],"version-history":[{"count":0,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/posts\/12704\/revisions"}],"wp:attachment":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/media?parent=12704"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories?post=12704"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/tags?post=12704"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}