Immunizations for renal transplant candidates and recipients

Abstract

Vaccine-preventable diseases are a major cause of morbidity and mortality in renal transplant candidates and recipients. Assessing the need for and providing appropriate vaccinations can greatly reduce the infectious complications associated with solid organ transplantation. This Review outlines the basic tenets of vaccination in solid organ transplant candidates and recipients and summarizes the available literature on the efficacy and safety of the most relevant vaccines for patients who are scheduled for or who have undergone renal transplantation.

Antibody responses to influenza vaccine in pre‐ and post‐lung transplant patients

“…These kidney transplant patients were found to have lower antibody responses compared to healthy controls (28). The recommended interval from transplantation to immunization, often six months, is based on expert opinion (12,29). This study represents the first to specifically measure vaccine-induced immune responses in the first six months following lung transplantation.…”

Immunization in End‐Stage Renal Disease: Opportunity to Improve Outcomes

“…Vaccines should be administered as early as possible before transplantation as vaccine efficacy is suboptimal posttransplantation. While live vaccines (measles‐mumps‐rubella and varicella vaccine) are contraindicated posttransplantation, the American Society of Transplantation guidelines recommend immunization with common killed vaccines in all kidney transplant recipients (Table ). For unvaccinated transplant recipients, vaccination with inactivated vaccines can be restarted 3–6 months after transplantation .…”

Topics in Transplantation Medicine for General Nephrologists

“…Immunologic response to vaccination does not appear to be affected based on use of tacrolimus, cyclosporine or sirolimus; however, both azathioprine and mycophenolate significantly reduced the immune response to most vaccines by 2.5-to 5-fold (79,80). Because vaccination activates cellular immunity, there has also been concern that transplant rejection may be precipitated by vaccination, but the literature does not support this concern (81,82).…”