The Predictive Value of Pre-transplant Immunoglobulin Level on Health-Related Quality of Life Measures at 6 and 12 months after Lung Transplantation

Health-related quality of life (HRQoL) is a patient-centered measure of outcomes based on patient-perceived physical and mental health. We hypothesized that pre-lung transplant Immunoglobulin levels would be associated with post-transplant HRQoL measures. This is a single center 2-year prospective observational study of 133 lung transplant recipients. HRQoL scores were measured with the SF-36 survey that was completed pre-transplant and at 3-month follow-up visits up to 24 months post-transplantation. Immunoglobulin levels were collected within 12 months prior to lung transplantation. Analysis was performed using non-parametric tests. Higher IgG level pre-transplant was positively associated with social function (Rho = +0.44, p = 0.04) and mental component score (Rho = +0.45, p = 0.03) at 6-months post-transplant. Higher IgG level pre-transplant was also positively associated with energy/fatigue (Rho = +0.5, p = 0.01) and general health (Rho = 0.4, p = 0.04) at 12 months post-lung transplant. IgG2 level <240 mg/dl were associated with lower overall HRQoL at 6 months post-transplant (p = 0.053) and 12 months post-transplant (p = 0.03). Higher IgG level prior to lung transplantation is associated with better post-transplant quality of life measures. Pre-transplant IgG2 level less than 240 mg/dl is associated with lower HRQoL at 6-months and 12-months post-lung transplant. The impact of post-transplant IgG levels on HRQoL and potential therapeutic benefits of immunoglobulin replacement therapy will require further study.