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儿童肝移植候选者常规疫苗接种免疫状态评估

Evaluation of immunity status to routine vaccination in pediatric liver transplant candidates.

作者信息

Dehghani Seyed Mohsen, Shakiba Mohammad Ali, Ziaeyan Maziyar, Imanieh Mohammad Hadi, Haghighat Mahmood, Sedaghat Majid, Alborzi Abdolvahab, Malek-Hosseini Seyed Ali

机构信息

Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran; Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.

出版信息

Turk J Gastroenterol. 2014 Dec;25 Suppl 1:26-31. doi: 10.5152/tjg.2014.5139.

Abstract

BACKGROUND/AIMS: Generally, prevention of infections by vaccination is the least invasive and most cost-effective approach to reduce the incidence of infections and the morbidity and mortality in transplant recipients. Genetic diversity and different liver disease among patients contributes to variability in immune responses to vaccines and pathogens. The aim of this study was to evaluate immunity status to different vaccinated organisms in pediatric liver-transplant candidates.

MATERIALS AND METHODS

The vaccination charts of 90 patients who were referred to Organ Transplant Center of Shiraz University of Medical Sciences were reviewed and compare with National Immunization Program recommendation, after that 10 mL blood was drawn from these patients for serologic studies by ELISA.

RESULTS

Eighty percent of the patients had protective antibody titers for poliomyelitis, 65.6% for rubella, 62.3% for diphtheria, 60% for tetanus, 57.7% for pertussis, 55.5% for measles, 42.2% for hepatitis B and 36.7% for mumps.

CONCLUSION

Overall seroconversion rates were not satisfactory for many infections that may be due to lower rate of vaccination or even the underlying liver disease that interfere with optimal immunogenecity of vaccination. Therefore, vaccination charts should be periodically reviewed and updated, also repeated measurements of serum antibodies and appropriate revaccination if titers decline is recommended to prevent the vaccine-preventable disease in liver transplant candidates after transplant.

摘要

背景/目的:一般来说,通过接种疫苗预防感染是降低移植受者感染发生率以及发病率和死亡率的侵入性最小且最具成本效益的方法。患者之间的基因多样性和不同的肝脏疾病导致对疫苗和病原体的免疫反应存在差异。本研究的目的是评估小儿肝移植候选者对不同接种疫苗生物体的免疫状态。

材料与方法

回顾了90名转诊至设拉子医科大学器官移植中心患者的疫苗接种记录,并与国家免疫规划建议进行比较,之后从这些患者中抽取10毫升血液,通过酶联免疫吸附测定法进行血清学研究。

结果

80%的患者对脊髓灰质炎有保护性抗体滴度,65.6%对风疹有保护性抗体滴度,62.3%对白喉有保护性抗体滴度,60%对破伤风有保护性抗体滴度,57.7%对百日咳有保护性抗体滴度,55.5%对麻疹有保护性抗体滴度,42.2%对乙型肝炎有保护性抗体滴度,36.7%对腮腺炎有保护性抗体滴度。

结论

对于许多感染,总体血清转化率并不理想,这可能是由于疫苗接种率较低,甚至是潜在的肝脏疾病干扰了疫苗的最佳免疫原性。因此,应定期审查和更新疫苗接种记录,还建议重复测量血清抗体,若滴度下降则进行适当的重新接种,以预防肝移植候选者移植后发生疫苗可预防的疾病。

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