Influenza Vaccination in Liver Transplant Recipients

Abstract

Our results show that the vaccine is safe and effective and should be recommended to TXL-R.

Influenza Infection in Patients Before and After Liver Transplantation

“…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. 65 Seroconversion was defined as a postvaccination titer of 1:40 or greater or a 4-fold increase of the prevaccination titer.…”

“…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. 65 Seroconversion was defined as a postvaccination titer of 1:40 or greater or a 4-fold increase of the prevaccination titer. In a recent study, Soesman et al 66 found a seroconversion rate of 68% in liver transplant recipients after 1 dose of the vaccine, which increased to 80% after a second dose.…”

“…To our knowledge, only 5 studies are available on the efficacy of influenza vaccination in liver transplant recipients: 2 studies of pediatric populations 62,63 and 3 studies of adult populations. [64][65][66] Data on patients with cirrhosis are limited to 1 study. 66 For this reason, most of the information on the safety and efficacy of vaccination is extrapolated from studies of other solid-organ or bone marrow transplant recipients, as well as other immunodepressed populations (Tables 2 and 3).…”

“…65 For this reason, vaccination should be performed during October and the first 2 weeks of November to protect patients by the time of the expected seasonal epidemic. However, patients who have not been administered the vaccine by mid-November should still be offered the vaccine at that time.…”

Guillain-Barré syndrome triggered by influenza vaccination in a recipient of liver transplant on FK506

“…18 Influenza vaccination has reduced the morbidity and perhaps the mortality from influenza virus infection in liver transplant patients with protective post-immunization antibodies. [19][20][21] Its safety and efficacy in liver transplant and other solid-organ recipients have been proven in several studies. 19,[21][22][23][24][25] Although our case suggests that GBS may occur in liver transplant recipients after influenza vaccination, the very low incidence of vaccine-associated GBS, the significantly increased complications from influenza virus infection in solid organ recipients, and the rise of influenza drug resistance make influenza vaccination the first-line strategy for influenza virus infection prevention in solid-organ recipients.…”