The High Price of Rejection: Kidney-Saving IVIG That Doesn't Cost a Fortune

Document Type

Conference Proceeding

Publication Date

3-6-2026

Publication Title

Am J Health Syst Pharm

Keywords

Pharmacology & Pharmacy

Abstract

Purpose: Antibody-mediated rejection (AMR) is a leading cause of kidney allograft dysfunction and failure. Intravenous immunoglobulin (IVIG) is the mainstay treatment for AMR, but treatment protocols and durations vary by institution. Most patients begin a 6-month IVIG course, yet effectiveness is often assessed only at renewal rather than at defined endpoints. Additionally, an analysis of U.S. CMS claims data found that patients being treated for AMR incurred $85,546 more in healthcare costs. This project aims to identify current IVIG usage patterns in kidney transplant patients with the future goal of optimizing therapy, enabling therapy tracking, and reducing costs. Methods: This proposed study will be an IRB-approved medication use evaluation within Henry Ford Health (HFH) outpatient infusion centers. Patients treated with outpatient IVIG for AMR from January 1st, 2018 – January 31st, 2025, will be screened for inclusion. Patients will be included in this study if they have a history of kidney transplant and received outpatient IVIG through a therapy plan with the indication of AMR. Patients will be excluded if they are receiving IVIG for any indication other than treatment of AMR, if they receive IVIG through an infusion center not associated with HFH, or if IVIG is administered outside of a therapy plan. The primary endpoint is to describe the outpatient use of IVIG for the treatment of AMR. Secondary endpoints include evaluating cost of IVIG, number of times the therapy plan was renewed, and complications associated with treatment. Data collected will include demographics, total dose and number of doses received, duration of treatment, weight utilized to calculate dose, number of times therapy plan was renewed, and side effects reported. Descriptive statistics will be utilized for data analysis. A sample of 100 patients is targeted to allow for meaningful data description and analysis.

Volume

83

First Page

S802

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