Influenza vaccination in solid-organ transplant recipients

Cordero, Elisa; Manuel, Oriol

doi:10.1097/mot.0b013e3283592622

Cited by 33 publications

(36 citation statements)

References 75 publications

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“…The protection reported following trivalent inactivated influenza vaccination (29, 30) has not always been observed after vaccination against other viral illnesses (31, 32), perhaps because in contrast to influenza, people lack preexisting memory responses to these other viruses. Even with influenza vaccination, the response in transplanted patients is often blunted (33, 34). …”

Section: Infections and Alloimmunitymentioning

confidence: 99%

Microbes and Allogeneic Transplantation

2014

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Summary Microbial products can be recognized by pattern recognition receptors (PRRs) expressed by immune and parenchymal cells and drive innate immunity that can in turn shape adaptive immune responses to microbial and transplant antigens. In transplanted patients, the signals and their downstream inflammatory cytokines elicited in response to infections can modulate ongoing alloimmune responses and modify the fate of transplanted organs. In recent years, it has become apparent that microbial signals can be generated not only by active pathogenic infections, but also by commensal microbiota thus opening a new field of research into the interplay between the microbiota and the immune system in homeostasis and disease. The wide use of antibiotics and immunosuppressive drugs in transplanted patients can have dramatic consequences on the microbiota that can, in turn, shape immune responses and perhaps alloresponses, whereas the ongoing immune responses can in turn affect the commensal or pathogenic microorganisms in a feed-forward circle. Here, we discuss known and hypothesized mechanisms for how infections or microbiota-derived signals may affect local or systemic alloimmunity and briefly review data on downstream effects of antibiotics and vaccinations.

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Section: Infections and Alloimmunitymentioning

confidence: 99%

Microbes and Allogeneic Transplantation

2014

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“…In addition, conflicting data exist on immune responses to influenza vaccine in this population. Some studies demonstrate lower antibody responses in SOT recipients when compared to age‐matched healthy controls, while another study revealed similar antibody titers, but decreased interferon gamma production in SOT recipients when compared to controls . Recently, a HD trivalent inactive influenza vaccine (Fluzone HD) with four times the standard antigenic dose was approved for use in individuals ≥65 yr of age.…”

mentioning

confidence: 99%

Randomized, double‐blind comparison of standard‐dose vs. high‐dose trivalent inactivated influenza vaccine in pediatric solid organ transplant patients

GiaQuinta

Michaels

McCullers

et al. 2014

Pediatric Transplantation

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Children who have undergone SOT mount a lower immune response after vaccination with TIV compared to healthy controls. HD or SD TIV in pediatric SOT was given to subjects 3-17 yr and at least six months post-transplant. Subjects were randomized 2:1 to receive either the HD (60 μg) or the SD (15 μg) TIV. Local and systemic reactions were solicited after each vaccination, and immune responses were measured before and after each vaccination. Thirty-eight subjects were enrolled. Mean age was 11.25 yr; 68% male, 45% renal, 26% heart, 21% liver, 5% lung, and 5% intestinal. Twenty-three subjects were given HD and 15 SD TIV. The median time since transplant receipt was 2.2 yr. No severe AEs or rejection was attributed to vaccination. The HD group reported more tenderness and local reactions, fatigue, and body ache when compared to the SD cohort, but these were considered mild and resolved within three days. Subjects in the HD group demonstrated a higher percentage of four-fold titer rise to H3N2 compared to the SD group. HD influenza vaccine was well tolerated and may have increased immunogenicity. A phase 2 trial is needed to confirm.

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“…Influenza is associated with significant morbidity in solidorgan transplant (SOT) recipients [1,2]. While the main preventive strategy against influenza after transplantation remains annual influenza vaccination [3], the immunogenicity and efficacy of influenza vaccine are suboptimal in this population [4].…”

Section: Introductionmentioning

confidence: 99%