Table 1 PICOS breakdown of study eligibility criteria

Population

Adults undergoing solid organ transplant (including the heart, lung, liver, kidney, intestine, and pancreas)

Intervention

Polyvalent immunoglobulin prophylaxis or polyvalent immunoglobulin treatment without restriction to dosage, frequency, timing, and route of administration

Comparator(s)

Placebo or no treatment. Patients may receive antimicrobial prophylaxis, which should be the same in both intervention and control arms

Outcome(s)

Primary outcome:

1) Overall rate of infection

2) Rate of infection based on severity: non-severe infection, severe infection, and serious/fatal infection

Secondary outcomes:

1) Hospital admission, initial length of stay, and number of re-admissions in the first year after transplantation;

2) ICU admission;

3) 1-year all-cause mortality;

4) Incidence of acute rejection;

5) Allograft survival at 1 year after transplantation

6) Adverse events graded by severity [21]

Study design

Both randomized controlled trials and non-randomized studies including case series with a minimum of 20 cases will be included. Case reports and studies that only focus on immunoglobulin use for de-sensitization purposes will be excluded