Prelog M, Pohl M, Ermisch B, Fuchshuber A, Huzly D, Jungraithmayr Th, Forster J, Zimmerhackl L B
Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria.
Pediatr Transplant. 2007 Feb;11(1):73-6. doi: 10.1111/j.1399-3046.2006.00602.x.
Vaccinations are recommended for achieving protection against vaccine-preventable infections in solid-organ transplant recipients. In order to evaluate the protection at the time of renal transplantation, the antibody titers against measles, mumps, rubella, varicella, hepatitis B, diphtheria, and tetanus were determined in 35 children one month prior to transplantation. Only 26% of patients on dialysis listed for transplantation showed protective antibodies against all tested pathogens. Particularly, low protection was found for hepatitis B. Children younger than four yr showed significantly lower protective antibody titers compared with older children for almost all vaccines. Children who completed vaccination in the last six months to six yr prior to renal transplantation showed higher rates of protective antibody titers against all pathogens compared with children who had vaccination more than six yr before transplantation. Preventive strategies in children with chronic renal failure include repeated measurements of serum antibodies and appropriate revaccination if titers decline. Our results underline the demand for continuous surveillance of specific antibody titers against vaccine-preventable diseases in the risk group of renal transplant recipients.
建议对实体器官移植受者进行疫苗接种，以预防可通过疫苗预防的感染。为了评估肾移植时的保护情况，在35名儿童移植前1个月测定了其针对麻疹、腮腺炎、风疹、水痘、乙型肝炎、白喉和破伤风的抗体滴度。在等待移植的透析患者中，只有26%的患者对所有检测病原体都有保护性抗体。特别是，乙型肝炎的保护率较低。与大龄儿童相比，4岁以下儿童几乎对所有疫苗的保护性抗体滴度都显著较低。在肾移植前最后6个月至6年完成疫苗接种的儿童，与移植前6年以上接种疫苗的儿童相比，对所有病原体的保护性抗体滴度率更高。慢性肾衰竭儿童的预防策略包括重复检测血清抗体，以及在滴度下降时进行适当的重新接种。我们的结果强调了对肾移植受者风险组中针对可通过疫苗预防疾病的特异性抗体滴度进行持续监测的必要性。
