Influenza Vaccination in Kidney Transplant Recipients: Cellular and Humoral Immune Responses

Briggs, William A.; Rozek, Richard J.; Migdal, Stephen D.; Shillis, Joan L.; Brackett, Robert G.; Brandon, Frank B.; Mahajan, S K; McDonald, Franklin D.

doi:10.7326/0003-4819-92-4-471

Cited by 55 publications

(31 citation statements)

References 12 publications

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“…Three studies have shown normal antibody responses when compared to controls [10,23,24] while several others have described impaired immunogenicity [3,[17][18][19][20]25]. In two of the studies with normal antibody production, prednisone and azathioprine were the only immunosuppressants used.…”

Section: Discussionmentioning

confidence: 99%

The humoral immune response to influenza vaccination in lung transplant patients

Mazzone

Mossad

Mawhorter

et al. 2001

European Respiratory Journal

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The purpose of this study was to evaluate the humoral immune response to influenza vaccination in lung transplant recipients.Antibody levels to the three viral antigens included in the 1999-2000 trivalent influenza vaccine (A/Sydney/5/97-like (H3N2), A/Beijing262/95-like (H1N1), and B/Yamanashi/16/ 98) were measured before and 4 weeks postvaccination in 43 lung transplant recipients and 21 healthy adult controls. The ability to develop protective antibody levels, a serological response, and the magnitude of change in levels were assessed.The humoral immune response to influenza vaccination was significantly lower in the transplant group for all three viral antigens. To A/Sydney, 95% of the control group and 40% of the transplant group developed protective levels (p=0.0009); to A/Beijing, 71% of the control group and 30% of the transplant group developed protective levels (p=0.004); and to B/Yamanashi, 48% of the control group and 19% of the transplant group developed protective levels (p=0.02). Those receiving cyclosporine had lower antibody responses when compared to those receiving tacrolimus (r=-0.3056, p=0.0463).The humoral immune response to influenza vaccination in lung transplant recipients is poor. Lung transplant recipients receiving cyclosporine may have a lower antibody response than those receiving tacrolimus. Alternative prevention strategies may be needed. Eur Respir J 2001; 18: 971-976.

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Section: Discussionmentioning

confidence: 99%

The humoral immune response to influenza vaccination in lung transplant patients

Mazzone

Mossad

Mawhorter

et al. 2001

European Respiratory Journal

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“…Efficacy in immunodepressed individuals is described as adequate in renal and heart transplant recipients by some investigators. 47,67 Adult liver transplant recipients have also been reported to be adequately protected by the vaccine. In the study of Burbach et al, 65 protective postimmunization titers at 21 days for the 3 antigens contained in the vaccine (A/Bayern/07/95, A/Wuhan/359/95, and B/Bejing/ 184/93) were 92%, 92%, and 95% in liver transplant recipients compared with 97%, 100%, and 100% in healthy controls, respectively.…”

Section: Vaccinationmentioning

confidence: 99%

“…This event, although not well described in liver transplant recipients, is extensively documented after renal transplantation. [47][48][49][50] In the study of Mauch et al, 45 3 children with influenza had concurrent allograft rejection. Viruses other than influenza have been associated with the development of rejection in solid-organ transplant recipients.…”

Section: Risk For Influenza Infection In Patients After Liver Transplmentioning

confidence: 99%

Influenza Infection in Patients Before and After Liver Transplantation

Duchini¹

2000

Liver Transplantation

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Infection with influenza virus poses specific problems in pediatric and adult liver transplant recipients, both before and after liver transplantation. These include a higher rate of pulmonary and extrapulmonary complications, development of rejection with graft dysfunction, prolonged shedding of influenza virus, and increased drug-resistance. Hepatic decompensation may occur during influenza infection in patients with cirrhosis. Current prophylaxis includes yearly vaccination with trivalent inactivated vaccine. Appropriate diagnosis and prompt treatment of any upper respiratory infections are indicated in these patients. In this review, we describe a case of influenza viral pneumonia in an adult liver transplant recipient, review basic and clinical aspects of influenza infection in this patient population, and discuss current modes of prevention and treatment in detail. (Liver Transpl 2000;6: 531-542.)

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“…Immune response in renal and heart transplant recipients has been described both adequate and impaired (2,9,13,16,98). Fraund et al vaccinated 79 heart recipients with the 1996/ 1997 trivalent vaccine.…”

Section: Influenza Vaccinementioning

confidence: 99%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population

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Influenza Vaccination in Kidney Transplant Recipients: Cellular and Humoral Immune Responses

Cited by 55 publications

References 12 publications

The humoral immune response to influenza vaccination in lung transplant patients

The humoral immune response to influenza vaccination in lung transplant patients

Influenza Infection in Patients Before and After Liver Transplantation

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

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