Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada.
Curr Opin Infect Dis. 2018 Aug;31(4):309-315. doi: 10.1097/QCO.0000000000000461.
The aim of this study was to highlight recent evidence on important aspects of influenza vaccination in solid organ transplant recipients.
Influenza vaccine is the most evaluated vaccine in transplant recipients. The immunogenicity of the vaccine is suboptimal after transplantation. Newer formulations such as inactivated unadjuvanted high-dose influenza vaccine and the administration of a booster dose within the same season have shown to increase response rates. Intradermal vaccination and adjuvanted vaccines did not show clear benefit over standard influenza vaccines. Recent studies in transplant recipients do not suggest a higher risk for allograft rejection, neither after vaccination with a standard influenza vaccine nor after the administration of nonstandard formulation (high-dose, adjuvanted vaccines), routes (intradermally) or a booster dose. Nevertheless, influenza vaccine coverage in transplant recipients is still unsatisfactory low, potentially due to misinterpretation of risks and benefits.
Annual influenza vaccination is well tolerated and is an important part of long-term care of solid organ transplant recipients.
本研究旨在强调关于实体器官移植受者流感疫苗接种的几个重要方面的最新证据。
流感疫苗是移植受者中评估最多的疫苗。接种后,疫苗的免疫原性并不理想。新的配方,如无佐剂的灭活高剂量流感疫苗和在同一季节内接种加强剂量,已被证明可提高反应率。皮内接种和佐剂疫苗并未显示出比标准流感疫苗有明显的优势。最近的研究在移植受者中并未表明同种异体移植物排斥的风险增加,无论是接种标准流感疫苗还是接种非标准配方(高剂量、佐剂疫苗)、接种途径(皮内)或加强剂量后。然而,移植受者的流感疫苗接种覆盖率仍然很低,这可能是由于对风险和益处的误解。
每年接种流感疫苗耐受性良好,是实体器官移植受者长期护理的重要组成部分。