Intravenous immunoglobulins in liver transplant patients: Perspectives of clinical immune modulation

Table 1 Clinical data of prognostic relevant immune modulation by hepatitis B hyperimmunoglobulin after liver transplantation

Ref.	No. of patients receiving HBIg	Efficacy of HBIg on immunology/survival
Farges et al[80]	n = 116	Significant reduction (P < 0.05) of acute and chronic rejection rate (1.7%) compared to other indications like PBC (6.1%), PSC (13%), AIC (17%), and HCV (9.2%), without increased risk of bacterial infection; significantly lower risk (P < 0.05) of death or retransplantation from rejection or either sepsis or de novo malignancy (3.5%) compared to patients with alcoholic cirrhosis (19%)
Couto et al[81]	n = 12	Significantly less acute rejection episodes (0.3 ± 0.5) as compared to HBsAg-positive (0.9 ± 0.7; P = 0.02) and HBsAg-naïve (0.7 ± 0.7; P = 0.03) liver transplant patients without HBIg therapy
Kwekkeboom et al[82]	n = 40	Sigificantly lower rate of acute rejection (12%) as compared to patients without viral hepatitis (34%; P = 0.012); only HBIg treatment (HR = 0.39, 95%CI: 0.16-0.99, P = 0.047) and year of LT (HR = 0.87, 95%CI: 0.78-0.98, P = 0.017) were identified as independent predictors of acute rejection
Wang et al[83]	n = 1000	Reduction of HBV recurrence rate and of viral mutants; significantly improved 1-yr (P = 0.03) and 3-yr survival (P = 0.005) as compared to an antiviral prophylaxis without HBIg

HBIg: Hepatitis B hyperimmunoglobulin; HBV: Hepatitis B virus; HCV: Hepatitis C virus; LT: Liver transplantation; PBC: Primary biliary cirrhosis; PSC: Primary sclerosing cirrhosis; AIC: Autoimmune cirrhosis; HBsAg: Hepatitis B surface antigen.