Serum immunoglobulin G concentration after plasma transfusion in neonatal foals with hypogammaglobulinemia in various health status.
Authors: Sievert Maren, Schuler Gerhard, Wehrend Axel
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Plasma transfusion remains the standard intervention for neonatal foals presenting with inadequate colostral immunoglobulin absorption, yet clinicians have limited data on the kinetics and efficacy of this treatment across different patient populations. Sievert and colleagues measured serum IgG concentrations in 23 hypogammaglobulinaemic foals before transfusion, at one hour post-transfusion, and again at 24 hours, examining both the magnitude of response and the relationship between transfused IgG volume and serum concentration increases. Whilst 78% of foals showed improved IgG levels, the response was highly variable: each milligram of transfused IgG increased serum concentration by an average of 0.03 mg/dl at one hour and 0.05 mg/dl at 24 hours, though individual responses ranged from negligible to 0.537 mg/dl—importantly, one in five foals showed no measurable improvement regardless of transfusion. No adverse reactions were observed across the cohort, confirming safety, but the marked individual variability underscores that post-transfusion IgG monitoring is essential rather than optional, preventing practitioners from relying on calculated plasma volumes alone to achieve adequate passive immunity.
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Practical Takeaways
- •Plasma transfusion is an effective treatment for hypogammaglobulinemia in most neonatal foals, but approximately 1 in 5 foals may show no IgG response—necessitating individual monitoring
- •Post-transfusion IgG levels should be monitored at 1 and 24 hours to assess treatment effectiveness, as responses vary significantly between foals
- •Use these findings as reference values to calculate transfusion volumes needed to achieve target IgG concentrations in individual foals, though expect considerable individual variation
Key Findings
- •78.3% of foals (18/23) showed increased serum IgG concentration after plasma transfusion, while 21.7% (5/23) showed no increase
- •1 mg IgG transfused caused an average increase of 0.03 mg/dl at 1 hour post-transfusion and 0.05 mg/dl at 24 hours post-transfusion
- •High variability in serum IgG concentration response was observed across individual foals after plasma transfusion
- •No adverse reactions to plasma transfusion were observed in any of the 23 foals studied