Prelog Martina, Zimmerhackl Lothar Bernd
Department of Pediatrics, Pediatrics I, Medical University Innsbruck, Anichstr. 35, A-6020 Innsbruck, Austria.
Pediatr Transplant. 2010 Feb;14(1):41-7. doi: 10.1111/j.1399-3046.2009.01204.x.
Reports about efficacy and safety of live-virus attenuated vaccines in patients before and after transplantation are mainly based on small patient numbers, making general recommendations for this patient population difficult. Children and adults as well as their close relatives and contact persons should be preferably immune to VZV before solid organ transplantation to avoid VZV-associated complications, thus making VZV vaccination necessary in susceptible individuals. The following literature review focused on efficacy and safety of VZV vaccination in pediatric kidney and liver transplant recipients. Review of literature also revealed that in all pediatric transplant candidates, humoral and cellular immunity against VZV should be consistently monitored to assess waning immunity under immunosuppressive treatment. This approach is desirable to estimate the risk of severe varicella disease after exposure in these patients.
关于减毒活疫苗在移植前后患者中的疗效和安全性的报告主要基于少量患者,因此难以针对该患者群体给出一般性建议。儿童和成人及其近亲与密切接触者在实体器官移植前最好对水痘带状疱疹病毒(VZV)具有免疫力,以避免VZV相关并发症,因此易感个体有必要接种VZV疫苗。以下文献综述聚焦于VZV疫苗在小儿肾移植和肝移植受者中的疗效和安全性。文献综述还显示,对于所有小儿移植候选者,应持续监测其针对VZV的体液免疫和细胞免疫,以评估免疫抑制治疗下免疫力的减弱情况。这种方法有助于评估这些患者接触病毒后发生重症水痘疾病的风险。