Safety of Ultra-Rapid Intravenous Infusion of Hepatitis B Immunoglobulin in Liver Transplant Recipients

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http://www.transplantation-proceedings.org/article/PIIS0041134511003198/abstract\

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TRANSPLANTATION PROCEEDINGS

Volume 43, Issue 5, Pages 1780-1782 (June 2011)

Safety of Ultra-Rapid Intravenous Infusion of Hepatitis B Immunoglobulin in

Liver Transplant Recipients

S. Hwangab, Y.D. Yua, G.C. Parka, Y.I. Choia, P.J. Parka, S.W. Junga, J.M.

Namgoonga, S.Y. Yoona, H.S. Hab, J.J. Hongb, I.O. Kimb, M.K. Jeonb, J.E. Mab,

S.Y. Choia, J.S. Yuna, D.H. Junga, G.W. Songa, T.Y. Haa, D.B. Moona, K.H. Kimya,

C.S. Ahna, S.G. Leeab

Abstract

Purpose

To evaluate the safety of institutional protocol for ultra-rapid hepatitis B

immunoglobulin (HBIG) infusion (10,000 IU in 30 minutes) for hepatitis B virus

prophylaxis in adult liver transplant recipients.

Methods

In this case-controlled study, prospectively recruited liver transplant

recipients received ultra-rapid infusions of HBIG (10,000 units in 30 minutes)

for 6 months. The historical control group consisted of patients who had

received 1-hour HBIG infusions (conventional rapid infusion) for the precedent 6

months.

Results

We found that 1472 patients had received 5744 ultra-rapid HBIG infusions,

whereas 1343 patients had received 5200 conventional rapid HBIG infusions.

Adverse side-effects were observed after 7 (0.13%) and 9 (0.16%) infusions,

respectively (P = .763). The number of infusions per month increased

significantly, from 878 ± 34 before the introduction of ultra-rapid infusion to

957 ± 29 afterwards (P < .001), an increase of 10.5%. The maximal capacity of

HBIG infusions per day in the outpatient clinic increased from 53 for

conventional rapid infusion to 65 for ultra-rapid infusion, without expansion of

the outpatient facility or equipment.

Conclusions

Nearly all adult liver recipients able to tolerate 1-hour infusions of HBIG can

also tolerate ultra-rapid infusions well. Thus, it seems to be reasonable to

perform ultra-rapid infusion protocol widely for patient convenience.

a Division of Hepatobiliary Surgery and Liver Transplantation, Department of

Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,

Korea

b Organ Transplantation Center, Asan Medical Center, University of Ulsan College

of Medicine, Seoul, Korea

Address reprint requests Shin Hwang, MD, Division of Hepatobiliary Surgery and

Liver Transplantation, Department of Surgery, Asan Medical Center, University of

Ulsan College of Medicine, Seoul, 138-736, Korea

PII: S0041-1345(11)00319-8

doi:10.1016/j.transproceed.2011.02.013

© 2011 Elsevier Inc. All rights reserved.

[Guest guest]

http://www.transplantation-proceedings.org/article/PIIS0041134511003198/abstract\

?rss=yes

TRANSPLANTATION PROCEEDINGS

Volume 43, Issue 5, Pages 1780-1782 (June 2011)

Safety of Ultra-Rapid Intravenous Infusion of Hepatitis B Immunoglobulin in

Liver Transplant Recipients

S. Hwangab, Y.D. Yua, G.C. Parka, Y.I. Choia, P.J. Parka, S.W. Junga, J.M.

Namgoonga, S.Y. Yoona, H.S. Hab, J.J. Hongb, I.O. Kimb, M.K. Jeonb, J.E. Mab,

S.Y. Choia, J.S. Yuna, D.H. Junga, G.W. Songa, T.Y. Haa, D.B. Moona, K.H. Kimya,

C.S. Ahna, S.G. Leeab

Abstract

Purpose

To evaluate the safety of institutional protocol for ultra-rapid hepatitis B

immunoglobulin (HBIG) infusion (10,000 IU in 30 minutes) for hepatitis B virus

prophylaxis in adult liver transplant recipients.

Methods

In this case-controlled study, prospectively recruited liver transplant

recipients received ultra-rapid infusions of HBIG (10,000 units in 30 minutes)

for 6 months. The historical control group consisted of patients who had

received 1-hour HBIG infusions (conventional rapid infusion) for the precedent 6

months.

Results

We found that 1472 patients had received 5744 ultra-rapid HBIG infusions,

whereas 1343 patients had received 5200 conventional rapid HBIG infusions.

Adverse side-effects were observed after 7 (0.13%) and 9 (0.16%) infusions,

respectively (P = .763). The number of infusions per month increased

significantly, from 878 ± 34 before the introduction of ultra-rapid infusion to

957 ± 29 afterwards (P < .001), an increase of 10.5%. The maximal capacity of

HBIG infusions per day in the outpatient clinic increased from 53 for

conventional rapid infusion to 65 for ultra-rapid infusion, without expansion of

the outpatient facility or equipment.

Conclusions

Nearly all adult liver recipients able to tolerate 1-hour infusions of HBIG can

also tolerate ultra-rapid infusions well. Thus, it seems to be reasonable to

perform ultra-rapid infusion protocol widely for patient convenience.

a Division of Hepatobiliary Surgery and Liver Transplantation, Department of

Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,

Korea

b Organ Transplantation Center, Asan Medical Center, University of Ulsan College

of Medicine, Seoul, Korea

Address reprint requests Shin Hwang, MD, Division of Hepatobiliary Surgery and

Liver Transplantation, Department of Surgery, Asan Medical Center, University of

Ulsan College of Medicine, Seoul, 138-736, Korea

PII: S0041-1345(11)00319-8

doi:10.1016/j.transproceed.2011.02.013

© 2011 Elsevier Inc. All rights reserved.