Safe Living Following Solid Organ Transplantation

Blair, Barbra M.

doi:10.1016/j.suc.2018.09.011

Cited by 10 publications

(22 citation statements)

References 24 publications

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“…recipients. [1][2][3][4][5][6] For example, measles can lead to severe complications in immunocompromised hosts including pneumonitis and encephalitis. 7 Varicella is associated with acute rejection episodes in pediatric renal transplants, with fewer severe cases reported in vaccinated individuals.…”

Section: Introductionmentioning

confidence: 99%

Serologic evaluation of vaccine preventable infections and vaccination rates in kidney transplant candidates

Schneider

Carlson

Sirandas

et al. 2022

Transplant Infectious Dis

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Introduction Assessing vaccine serologic status presents opportunities to provide live vaccinations to kidney transplant candidates (KTC). This is especially important given the increased risk of infection while taking lifelong immunosuppression following transplant and the inability to routinely provide live vaccines to patients on immunosuppressive medications. In March 2019, the American Society of Transplantation Infectious Disease Community of Practice (AST‐IDCOP) released updated guidelines for vaccination of KTC, which emphasize pretransplant viral serology screening and live vaccine administration prior to transplant. Primary Endpoint The primary endpoint of this study was to determine adherence to AST‐IDCOP guidelines for live measles, mumps, and rubella (MMR) and VZV vaccination prior to transplant in KTC non‐immune by serology. Methods This retrospective, descriptive study examined serologic status and rates of live vaccination in 672 patients listed for kidney transplant at our center between July 2014 and July 2019. Secondary endpoints included subgroup analysis of adherence to full AST‐IDCOP vaccination recommendations and validation of CDC presumed immunity definitions for measles and VZV. Results Seventeen patients (2.7%) were nonimmune by serology for VZV, while 182 (27.1%) were nonimmune by serology to MMR. In a subgroup analysis of the seronegative KTC, none received VZV vaccination, and 6% received MMR vaccination prior to transplant or last follow‐up. Conclusions Overall, a large portion of KTC had immunity gaps that were not resolved before transplantation. These findings are limited due to the retrospective, single‐center nature of this study and should be confirmed with larger, prospective assessments of serologic status and vaccine administration.

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Section: Introductionmentioning

confidence: 99%

Serologic evaluation of vaccine preventable infections and vaccination rates in kidney transplant candidates

Schneider

Carlson

Sirandas

et al. 2022

Transplant Infectious Dis

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“…Live attenuated vaccines are not safe to give to all immunocompromised individuals . In addition to immunosuppression, after solid organ transplantation, the antibody response is significantly reduced by the effects of various factors . Infectious disease consultation (IDC) before transplantation, determining patients’ immune status, and scheduling immunizations according to their serologic results are lifesaving steps to be followed by the providers.…”

Section: Introductionmentioning

confidence: 99%

Serologic screening and infectious disease consultation (IDC): Indicated in heart, lung, liver (HLL) solid organ transplants (SOT) for measles, mumps, rubella, and varicella

Seckin

Brumble

Libertin

2019

Transplant Infectious Dis

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Background Solid organ transplant (SOT) recipients are a special group of patients who require comprehensive evaluation for preventable infectious diseases before transplantation. The main aim of our study was to investigate the number of heart, lung, and liver (HLL) transplant recipients who were evaluated for their immune status against measles, mumps, rubella (MMR), and varicella (VZV). As a secondary aim, we investigated whether pre‐transplant infectious disease consultation (IDC) improves vaccination rates. Methods This study was an institution‐based retrospective analysis of HLL transplant recipients born in or after 1957 and evaluated at Mayo Clinic, FL Transplant Center between January 1st, 2016 and December 31st, 2017. Data collection was obtained from electronic medical records. The vaccination rates were compared by univariate analysis based on IDC and no ID consultation (NIDC). Results One hundred and eighty‐seven (77%) of a total 242 patients received an IDC pre‐transplantation. Varicella IgG levels were screened in all 187 IDC candidates. Among the 187 IDC patients, mumps, measles, and rubella IgG serologies were performed in 9 (5%), 21 (11%), and 51 (27%), respectively. Among all 242 patients, vaccines given included 2 (0.8%) MMR, 10 (4.1%) varicella and 85 (35.12%) Zostavax. Univariate analysis revealed that Zostavax was given to 76 (40.6%) pre‐transplant IDC patients and only in 9 (16.7%) NIDC patients (P < .001). Conclusions Despite the relatively high IDC rate, patients’ screened numbers for MMR IgG levels were low. Results pointed out the need for MMR protocol‐driven serologic screening as well as for VZV and IDC prior to transplantation to increase vaccination rates.

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“…Regarding the perception of risk for various types of pets, we compared the respondents' answers to the published guidelines (9)(10)(11)(12)(13). These guidelines discourage patients to own reptiles and turtles.…”

Section: Clinical Practice and Recommendations Regarding Petsmentioning

confidence: 99%

“…However, these are mostly based on experts' opinion or on case reports, without providing the strength of the recommendations and the quality of evidence grade ( 9 ), or provide poor quality and strength regarding most recommendations ( 10 ). The decision is therefore left to the discretion of the attending healthcare practitioner ( 9 , 11 – 13 ). The lack of evidence translates into great heterogeneity in clinical practice, in a context characterized by an increasing numbers of transplant recipients, along with a generalization of AATs.…”

Section: Introductionmentioning

confidence: 99%

Pets for pediatric transplant recipients: To have or not to have

et al. 2022

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Pets have many health, emotional and social benefits for children, but the risk of zoonotic infections cannot be underestimated, especially for immunosuppressed patients. We report the recommendations given by health professionals working with pediatric transplant recipients to their families regarding pet ownership. An online survey addressing zoonosis knowledge and recommendations provided by health care practitioners regarding pets was distributed to clinicians treating pediatric transplant recipients. The European Society of Pediatric Infectious Disease (ESPID) and the European Reference Network ERN-TransplantChild, which works to improve the quality of life of transplanted children, allowed the online distribution of the survey. A total of 151 practitioners from 28 countries participated in the survey. Up to 29% of the respondents had treated at least one case of zoonosis. Overall, 58% of the respondents considered that the current available evidence regarding zoonotic risk for transplanted children of having a pet is too scarce. In addition, up to 23% of the surveyed professionals recognized to be unaware or outdated. Still, 27% of the respondents would advise against buying a pet. Practitioners already owning a pet less frequently advised patients against pet ownership, whereas non-pet-owners were more keen to advise against pet ownership (p = 0.058). 61% of the participants stated that there were no institutional recommendations regarding pets in their centers/units. However, 43% of them reported therapeutic initiatives that involved animals in their centers. Infectious disease specialists were more likely to identify zoonotic agents among a list of pathogens compared to other specialists (p < 0.05). We have observed a huge heterogeneity among the recommendations that health care providers offer to families in terms of risk related to pet ownership for transplant recipients. The lack of evidence regarding these recommendations results in practitioners' recommendations based on personal experience.

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Safe Living Following Solid Organ Transplantation

Cited by 10 publications

References 24 publications

Serologic evaluation of vaccine preventable infections and vaccination rates in kidney transplant candidates

Serologic evaluation of vaccine preventable infections and vaccination rates in kidney transplant candidates

Serologic screening and infectious disease consultation (IDC): Indicated in heart, lung, liver (HLL) solid organ transplants (SOT) for measles, mumps, rubella, and varicella

Pets for pediatric transplant recipients: To have or not to have

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