ABSTRACT
Intravenous immunoglobulins clearly have an established role in solid organ transplantation, although many questions remain. The use of immunoglobulins, specifically CMVIG, in preventing CMV disease in high-risk renal transplant patients has been verified by randomized trials and now by meta-analysis. This benefit holds true for liver transplant recipients as well, although the efficacy of such therapy in other solid organ transplant recipients is less clear. In addition, the use of CMVIG in combination with an antiviral agent for prophylaxis in high-risk patients has become routine in many transplant centers. Similarly, the use of CMVIG plus antiviral therapy is commonly used for the treatment of established CMV disease. The use of HBIG is the standard of care for liver transplant recipients at risk for HBV recurrence. Standard IV immunoglobulin in solid organ transplant may be useful for susceptible patients with exposures to VZV when VZIG is not readily available. Finally, a future role for IV immunoglobulins in the prevention and treatment of PTLD has been postulated. The discrepancies in the existing data and the prospects for future use of IV immunoglobulins in solid organ transplantation should be further explored through carefully designed and controlled trials .
