Altamirano-Diaz Luis, West Lori, Humar Atul, Ely Leticia, Urschel Simon, Gubbay Jonathan, Crowcroft Natasha, Kumar Deepali
Pediatric Heart Transplant, Stollery Children's Hospital, Transplant Infectious Diseases, University of Alberta, Edmonton, AB, Canada.
Pediatr Transplant. 2011 Mar;15(2):172-5. doi: 10.1111/j.1399-3046.2010.01433.x. Epub 2010 Dec 22.
Pandemic influenza A/H1N1 virus has the potential to cause severe disease in pediatric transplant patients. A pandemic vaccine against H1N1 is effective in immunocompetent children. We investigated the immunogenicity of this vaccine when given in the first six months after heart transplantation. Four patients younger than two yr received two doses of vaccine and one patient older than seven yr received one dose. Titers were obtained using the HAI at baseline and after final immunization. Five patients were enrolled, ages 0.5-7 yr. Median age at the time of transplant was five months (range 3 wk-7 yr). All patients received induction with anti-thymoglobulin and maintenance immunosuppression with tacrolimus, MMF, and prednisone. Patients were immunized with the adjuvanted H1N1 vaccine after heart transplant at median time of nine wk (range 5-23 wk) post-transplant. Three of five developed protective titers against H1N1. A proportion of pediatric patients may respond to influenza vaccine even when immunized in the early post-transplant period.
甲型H1N1流感大流行病毒有可能在儿科移植患者中引发严重疾病。针对H1N1的大流行疫苗对免疫功能正常的儿童有效。我们研究了该疫苗在心脏移植后的头六个月内接种时的免疫原性。四名两岁以下的患者接种了两剂疫苗，一名七岁以上的患者接种了一剂。在基线和最后一次免疫后使用血凝抑制试验（HAI）获得滴度。招募了五名患者，年龄在0.5至7岁之间。移植时的中位年龄为五个月（范围为3周 - 7岁）。所有患者均接受了抗胸腺细胞球蛋白诱导治疗，并使用他克莫司、霉酚酸酯和泼尼松进行维持免疫抑制。患者在心脏移植后中位时间为移植后9周（范围为5 - 23周）时接种了含佐剂的H1N1疫苗。五名患者中有三名产生了针对H1N1的保护性滴度。即使在移植后早期进行免疫接种，一部分儿科患者可能对流感疫苗有反应。
