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Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study
Background We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation. Methods We prospectively analyzed 250 adu...
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| Published in: | Transplant infectious disease 2021-04, Vol.23 (2), p.e13494-n/a |
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| creator | Sarmiento, Elizabeth Jimenez, Maricela Natale, Marisa Rodriguez‐Ferrero, Marisa Anaya, Fernando Lopez‐Hoyos, Marcos Rodrigo, Emilio Arias, Manuel Perello, Manel Seron, Daniel Karanovic, Boris Ezzahouri, Ikram Mezzano, Sergio Jaramillo, Maria Calahorra, Leticia Alarcon, Alba Navarro, Joaquin Muñoz, Patricia Carbone, Javier |
| description | Background
We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation.
Methods
We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30 days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti‐PPS) determined using enzyme‐linked immunosorbent assay. The clinical follow‐up period lasted 6 months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression.
Results
At day 7, IgG hypogammaglobulinemia (IgG levels |
| doi_str_mv | 10.1111/tid.13494 |
| format | article |
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We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation.
Methods
We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30 days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti‐PPS) determined using enzyme‐linked immunosorbent assay. The clinical follow‐up period lasted 6 months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression.
Results
At day 7, IgG hypogammaglobulinemia (IgG levels < 700 mg/dL) combined with low IgG anti‐CMV antibody titers (defined as levels < 10 000 units) was present in 12% of kidney recipients. IgG hypogammaglobulinemia combined with low IgG anti‐PPS antibody titers (defined as levels < 10 mg/dL) at 1 month after kidney transplantation were recorded in 16% of patients. At day 7 the combination of IgG hypogammaglobulinemia and low anti‐CMV titers was independently associated with the development of CMV disease (odds ratio [OR], 6.95; 95% confidence interval [CI], 1.17‐41.31; P = .033). At day 30 after transplantation, the combination of IgG < 700 mg/dL and IgG anti‐PPS < 10 mg/dL, was independently associated with recurrent bacterial infection (OR, 5.942; 95% CI, 1.943‐18.172; P = .002).
Conclusion
In a prospective multicenter study, early immunologic monitoring of secondary antibody deficiency proved useful for the identification of kidney recipients who developed severe infection.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.13494</identifier><identifier>PMID: 33064917</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Antibodies ; Antiinfectives and antibacterials ; Bacterial diseases ; Bacterial infections ; Complement component C3 ; Complement component C4 ; Confidence intervals ; Cytomegalovirus ; Hypogammaglobulinemia ; IgG antibody ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; infection ; Infections ; Kidney transplantation ; Kidney transplants ; Nephelometry ; Polysaccharides ; Recurrent infection ; risk factors ; secondary antibody deficiency ; Statistical analysis</subject><ispartof>Transplant infectious disease, 2021-04, Vol.23 (2), p.e13494-n/a</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-370a6131ab71dd04e27e5c04a4ebf8bee50f2bd835e6b4aa7539b2092d96b6873</citedby><cites>FETCH-LOGICAL-c3534-370a6131ab71dd04e27e5c04a4ebf8bee50f2bd835e6b4aa7539b2092d96b6873</cites><orcidid>0000-0003-2056-0534 ; 0000-0001-5706-5583</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33064917$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sarmiento, Elizabeth</creatorcontrib><creatorcontrib>Jimenez, Maricela</creatorcontrib><creatorcontrib>Natale, Marisa</creatorcontrib><creatorcontrib>Rodriguez‐Ferrero, Marisa</creatorcontrib><creatorcontrib>Anaya, Fernando</creatorcontrib><creatorcontrib>Lopez‐Hoyos, Marcos</creatorcontrib><creatorcontrib>Rodrigo, Emilio</creatorcontrib><creatorcontrib>Arias, Manuel</creatorcontrib><creatorcontrib>Perello, Manel</creatorcontrib><creatorcontrib>Seron, Daniel</creatorcontrib><creatorcontrib>Karanovic, Boris</creatorcontrib><creatorcontrib>Ezzahouri, Ikram</creatorcontrib><creatorcontrib>Mezzano, Sergio</creatorcontrib><creatorcontrib>Jaramillo, Maria</creatorcontrib><creatorcontrib>Calahorra, Leticia</creatorcontrib><creatorcontrib>Alarcon, Alba</creatorcontrib><creatorcontrib>Navarro, Joaquin</creatorcontrib><creatorcontrib>Muñoz, Patricia</creatorcontrib><creatorcontrib>Carbone, Javier</creatorcontrib><title>Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation.
Methods
We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30 days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti‐PPS) determined using enzyme‐linked immunosorbent assay. The clinical follow‐up period lasted 6 months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression.
Results
At day 7, IgG hypogammaglobulinemia (IgG levels < 700 mg/dL) combined with low IgG anti‐CMV antibody titers (defined as levels < 10 000 units) was present in 12% of kidney recipients. IgG hypogammaglobulinemia combined with low IgG anti‐PPS antibody titers (defined as levels < 10 mg/dL) at 1 month after kidney transplantation were recorded in 16% of patients. At day 7 the combination of IgG hypogammaglobulinemia and low anti‐CMV titers was independently associated with the development of CMV disease (odds ratio [OR], 6.95; 95% confidence interval [CI], 1.17‐41.31; P = .033). At day 30 after transplantation, the combination of IgG < 700 mg/dL and IgG anti‐PPS < 10 mg/dL, was independently associated with recurrent bacterial infection (OR, 5.942; 95% CI, 1.943‐18.172; P = .002).
Conclusion
In a prospective multicenter study, early immunologic monitoring of secondary antibody deficiency proved useful for the identification of kidney recipients who developed severe infection.</description><subject>Antibodies</subject><subject>Antiinfectives and antibacterials</subject><subject>Bacterial diseases</subject><subject>Bacterial infections</subject><subject>Complement component C3</subject><subject>Complement component C4</subject><subject>Confidence intervals</subject><subject>Cytomegalovirus</subject><subject>Hypogammaglobulinemia</subject><subject>IgG antibody</subject><subject>Immunoglobulin A</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin M</subject><subject>infection</subject><subject>Infections</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Nephelometry</subject><subject>Polysaccharides</subject><subject>Recurrent infection</subject><subject>risk factors</subject><subject>secondary antibody deficiency</subject><subject>Statistical analysis</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kUtrFjEUhoMotlYX_gEJuNHFtLlOJu5KvRUKgtZ1yOUMps4kn5OMZdb-cfP1qy4Es8kL58nDIS9Czyk5pe2c1RhOKRdaPEDHlGvdcdKzh3d56BhT_Ag9KeWGEKq00I_REW-A0FQdo19fwOcU7LJhm2p0OWw4wBh9hOQ3HAu2pWQfbYWAb2P91qY_Ycq7GVLFecQxjeBrzKkl_D2GBBuui01lNzWh3U_e4M9Q1qmWPW_x3GL07TksuNQ1bE_Ro9FOBZ7d3yfo6_t31xcfu6tPHy4vzq86zyUXHVfE9pRT6xQNgQhgCqQnwgpw4-AAJBmZCwOX0DthrZJcO0Y0C7p3_aD4CXp18O6W_GOFUs0ci4epLQp5LYYJSQepKKMNffkPepPXJbXtDJO0H7SShDTq9YHySy5lgdHslji3vzSUmH0zpjVj7ppp7It74-pmCH_JP1U04OwA3MYJtv-bzPXl24PyNzB-mgw</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Sarmiento, Elizabeth</creator><creator>Jimenez, Maricela</creator><creator>Natale, Marisa</creator><creator>Rodriguez‐Ferrero, Marisa</creator><creator>Anaya, Fernando</creator><creator>Lopez‐Hoyos, Marcos</creator><creator>Rodrigo, Emilio</creator><creator>Arias, Manuel</creator><creator>Perello, Manel</creator><creator>Seron, Daniel</creator><creator>Karanovic, Boris</creator><creator>Ezzahouri, Ikram</creator><creator>Mezzano, Sergio</creator><creator>Jaramillo, Maria</creator><creator>Calahorra, Leticia</creator><creator>Alarcon, Alba</creator><creator>Navarro, Joaquin</creator><creator>Muñoz, Patricia</creator><creator>Carbone, Javier</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2056-0534</orcidid><orcidid>https://orcid.org/0000-0001-5706-5583</orcidid></search><sort><creationdate>202104</creationdate><title>Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study</title><author>Sarmiento, Elizabeth ; Jimenez, Maricela ; Natale, Marisa ; Rodriguez‐Ferrero, Marisa ; Anaya, Fernando ; Lopez‐Hoyos, Marcos ; Rodrigo, Emilio ; Arias, Manuel ; Perello, Manel ; Seron, Daniel ; Karanovic, Boris ; Ezzahouri, Ikram ; Mezzano, Sergio ; Jaramillo, Maria ; Calahorra, Leticia ; Alarcon, Alba ; Navarro, Joaquin ; Muñoz, Patricia ; Carbone, Javier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-370a6131ab71dd04e27e5c04a4ebf8bee50f2bd835e6b4aa7539b2092d96b6873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibodies</topic><topic>Antiinfectives and antibacterials</topic><topic>Bacterial diseases</topic><topic>Bacterial infections</topic><topic>Complement component C3</topic><topic>Complement component C4</topic><topic>Confidence intervals</topic><topic>Cytomegalovirus</topic><topic>Hypogammaglobulinemia</topic><topic>IgG antibody</topic><topic>Immunoglobulin A</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulin M</topic><topic>infection</topic><topic>Infections</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>Nephelometry</topic><topic>Polysaccharides</topic><topic>Recurrent infection</topic><topic>risk factors</topic><topic>secondary antibody deficiency</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sarmiento, Elizabeth</creatorcontrib><creatorcontrib>Jimenez, Maricela</creatorcontrib><creatorcontrib>Natale, Marisa</creatorcontrib><creatorcontrib>Rodriguez‐Ferrero, Marisa</creatorcontrib><creatorcontrib>Anaya, Fernando</creatorcontrib><creatorcontrib>Lopez‐Hoyos, Marcos</creatorcontrib><creatorcontrib>Rodrigo, Emilio</creatorcontrib><creatorcontrib>Arias, Manuel</creatorcontrib><creatorcontrib>Perello, Manel</creatorcontrib><creatorcontrib>Seron, Daniel</creatorcontrib><creatorcontrib>Karanovic, Boris</creatorcontrib><creatorcontrib>Ezzahouri, Ikram</creatorcontrib><creatorcontrib>Mezzano, Sergio</creatorcontrib><creatorcontrib>Jaramillo, Maria</creatorcontrib><creatorcontrib>Calahorra, Leticia</creatorcontrib><creatorcontrib>Alarcon, Alba</creatorcontrib><creatorcontrib>Navarro, Joaquin</creatorcontrib><creatorcontrib>Muñoz, Patricia</creatorcontrib><creatorcontrib>Carbone, Javier</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sarmiento, Elizabeth</au><au>Jimenez, Maricela</au><au>Natale, Marisa</au><au>Rodriguez‐Ferrero, Marisa</au><au>Anaya, Fernando</au><au>Lopez‐Hoyos, Marcos</au><au>Rodrigo, Emilio</au><au>Arias, Manuel</au><au>Perello, Manel</au><au>Seron, Daniel</au><au>Karanovic, Boris</au><au>Ezzahouri, Ikram</au><au>Mezzano, Sergio</au><au>Jaramillo, Maria</au><au>Calahorra, Leticia</au><au>Alarcon, Alba</au><au>Navarro, Joaquin</au><au>Muñoz, Patricia</au><au>Carbone, Javier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2021-04</date><risdate>2021</risdate><volume>23</volume><issue>2</issue><spage>e13494</spage><epage>n/a</epage><pages>e13494-n/a</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
We performed a multicenter study to assess the association between secondary antibody deficiency (immunoglobulin G [IgG] hypogammaglobulinemia combined with low levels of specific antibodies) and development of infection in kidney transplantation.
Methods
We prospectively analyzed 250 adult kidney recipients at four centers. The assessment points were before transplantation and 7 and 30 days after transplantation. The immune parameters were as follows: IgG, IgA, and IgM and complement factors C3 and C4 tested by nephelometry; specific IgG antibodies to cytomegalovirus (CMV) and IgG and IgG2 antibodies to pneumococcal polysaccharide (anti‐PPS) determined using enzyme‐linked immunosorbent assay. The clinical follow‐up period lasted 6 months. The clinical outcomes were CMV disease and recurrent bacterial infections requiring antimicrobial therapy. Statistics: Multivariate logistic regression.
Results
At day 7, IgG hypogammaglobulinemia (IgG levels < 700 mg/dL) combined with low IgG anti‐CMV antibody titers (defined as levels < 10 000 units) was present in 12% of kidney recipients. IgG hypogammaglobulinemia combined with low IgG anti‐PPS antibody titers (defined as levels < 10 mg/dL) at 1 month after kidney transplantation were recorded in 16% of patients. At day 7 the combination of IgG hypogammaglobulinemia and low anti‐CMV titers was independently associated with the development of CMV disease (odds ratio [OR], 6.95; 95% confidence interval [CI], 1.17‐41.31; P = .033). At day 30 after transplantation, the combination of IgG < 700 mg/dL and IgG anti‐PPS < 10 mg/dL, was independently associated with recurrent bacterial infection (OR, 5.942; 95% CI, 1.943‐18.172; P = .002).
Conclusion
In a prospective multicenter study, early immunologic monitoring of secondary antibody deficiency proved useful for the identification of kidney recipients who developed severe infection.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33064917</pmid><doi>10.1111/tid.13494</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-2056-0534</orcidid><orcidid>https://orcid.org/0000-0001-5706-5583</orcidid></addata></record> |
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| subjects | Antibodies Antiinfectives and antibacterials Bacterial diseases Bacterial infections Complement component C3 Complement component C4 Confidence intervals Cytomegalovirus Hypogammaglobulinemia IgG antibody Immunoglobulin A Immunoglobulin G Immunoglobulin M infection Infections Kidney transplantation Kidney transplants Nephelometry Polysaccharides Recurrent infection risk factors secondary antibody deficiency Statistical analysis |
| title | Secondary antibody deficiency is associated with development of infection in kidney transplantation: Results of a multicenter study |
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