Immunization after renal transplantation: current clinical practice

Struijk, Geertrude H.; Lammers, A.J.J.; Brinkman, Romy J.; Lombarts, Kiki M. J. M. H.; Vugt, Michèle van; Pant, Karlijn A M I van der; Berge, Ineke J. M. ten; Bemelman, Fréderike J.

doi:10.1111/tid.12368

Cited by 13 publications

(13 citation statements)

References 25 publications

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“…The most striking finding was the low vaccine coverage rate for the majority of vaccines, and that the underutilization of national and international vaccine guidelines. Adequate coverage was observed only for hepatitis B (73%) and Influenza (67%), similar to previous reports . One can argue that for some common childhood infectious diseases, the occurrence of previous contact and seroconversion could be present when starting dialysis, with no need for vaccines.…”

Section: Discussionsupporting

confidence: 87%

“…The low rates of referral for vaccination to CRIEs, and the low importance to the complete vaccine calendar besides hepatitis B and Influenza can explain the low rates of vaccine coverage in analyzed patients as well as their conception of the low importance of a complete vaccine card before transplant. Few studies linked the importance of health care team activity to increase the vaccination coverage in CKD patients in waiting list or after transplant . The overlap of vaccine curves, what RRT staff consider important and the immunization coverage of CKD patients suggests that educational campaigns on the importance of immunization should be carried out, directed not only to CKD patients, but specially for RRT clinics staff and caregivers.…”

Section: Discussionmentioning

confidence: 99%

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Immunization in end stage renal disease: The perception of waiting list patients

Camargo

Lother

Mazzali

et al. 2018

Transplant Infectious Dis

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Immunization in end stage renal disease: The perception of waiting list patients

Camargo

Lother

Mazzali

et al. 2018

Transplant Infectious Dis

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“…However, adherence to recommendations regarding immunization before and after transplantation is suboptimal and is consistent with low rates seen in the general population. A number of factors have been associated with low vaccination rates among transplant patients . Recent efforts and resources have focused on the development of coordinated interventions to improve the overall process of care delivery relating to immunizations.…”

Section: Discussionmentioning

confidence: 99%

Low rates of vaccination in listed kidney transplant candidates

Lee

Boyle

Malat

et al. 2016

Transplant Infectious Dis

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Despite clear consensus and strong recommendations, vaccination rates of kidney transplant (KT) recipients have remained below targets. As vaccination is most effective if it is given prior to transplantation and the initiation of immunosuppression, patients should ideally have their vaccination status assessed and optimized in the pre-transplant period. We performed a retrospective chart review to characterize vaccination rates and factors associated with gaps in vaccination in a single-center population of waitlisted patients being evaluated for kidney transplantation. We evaluated 362 KT patients. Three-quarters were receiving dialysis at the time of evaluation. Immunization rates were low with 35.9% of patients having completed vaccination for Pneumococcus, 55% for influenza, 6.9% for zoster, and 2.5% for tetanus. On multivariable analysis, patients who received other vaccines, including influenza, tetanus, or zoster vaccine (odds ratio [OR] 10.55, 95% confidence interval [CI] 5.65-19.71) were more likely to receive pneumococcal vaccine. Blacks (OR 0.24, 95% CI 0.12-0.47) were less likely to receive pneumococcal vaccine compared to whites. Patients on dialysis, and those active on the waiting list were more likely to receive pneumococcal vaccine than other groups (OR 2.81, 95% CI 1.44-5.51, and OR 1.84, 95% CI 1.08-3.14, respectively). We found that the overall immunization rate against common vaccine-preventable infections was low among patients evaluated for kidney transplantation. A significant gap remains between recommendations and vaccine uptake in clinical practice among this high-risk population.

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“…[12][13][14][15][16][17][18][19][20][21][22][23][24][25] The expectation of low effectiveness of currently licensed HBV vaccines in renal transplant recipients was shown to be the most important barrier to guideline adherence among Dutch nephrologists. 38 Similarly for liver transplant candidates, HBV immunity rate was significantly lower in patients with more advanced liver dis- should be immunized with the hepatitis B vaccine. 6 However, HBV vaccine coverage is estimated at only 29% in adults with chronic liver disease and 17% in adults with diagnosed diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

Koc

Dupont

Vos

et al. 2020

Journal of Viral Hepatitis

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Background Hepatitis B virus (HBV) immunity is recommended to optimize outcomes after solid organ transplantation (SOT). This study assessed the prevalence and predictors of HBV immunity at the time patients were placed on transplant waiting list over a period from 1997 to 2019 in a low HBV endemic region. Methods Data were obtained from the University Hospitals Leuven transplant database. Minors and patients with past/current HBV infection were excluded. From 1986, Belgian patients are covered by the universal infant vaccination; therefore, birth cohort was stratified in those born ≥1986 vs <1986. Results The study population consisted of 3297 SOT candidates. HBV immunity rate was superior in renal transplant candidates (55.3%), and this number was 21.5%, 15.4% and 16.8% for liver, cardiac and pulmonary transplant candidates, respectively, P < .001. Among liver transplant candidates, HBV immunity rate was 14.8% in decompensated cirrhotic patients and 27.9% in those without advanced cirrhosis (P < .001). The overall immunity rate increased from 19.3% in period 1997‐2008 to 32.8% in 2009‐2019, P < .001. In multivariable analyses, younger age (odds ratio (OR) 95% confidence interval (CI): 0.97‐0.98, P < .001) and birth cohort ≥ 1986 (OR 95% CI: 1.18‐2.66, P = .006) were associated with increased HBV immunity. Conclusion An increase in HBV immunity was observed over a 20‐year period related to the introduction of universal infant HBV vaccination. Nevertheless, this study highlights the low overall HBV immunity at the time of listing for organ transplantation and points out the need of an increased awareness and vaccination strategy at an early disease stage.

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Immunization after renal transplantation: current clinical practice

Cited by 13 publications

References 25 publications

Immunization in end stage renal disease: The perception of waiting list patients

Immunization in end stage renal disease: The perception of waiting list patients

Low rates of vaccination in listed kidney transplant candidates

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates

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