Department of Pediatrics and Pathology-Immunology, Center for Vaccinology and Neonatal Immunology, Medical Faculty and University Hospitals of Geneva, Geneva, Switzerland.
Department of Pediatrics, Children's Hospital of Geneva, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
Am J Transplant. 2019 Feb;19(2):512-521. doi: 10.1111/ajt.15097. Epub 2018 Oct 12.
Solid organ transplant (SOT) candidates may not be immune against potentially vaccine-preventable diseases because of insufficient immunizations and/or limited vaccine responses. We evaluated the impact on vaccine immunity at transplant of a systematic vaccinology workup at listing that included (1) pneumococcal with and without influenza immunization, (2) serology-based vaccine recommendations against measles, varicella, hepatitis B virus, hepatitis A virus, and tetanus, and (3) the documentation of vaccines and serology tests in a national electronic immunization registry (www.myvaccines.ch). Among 219 SOT candidates assessed between January 2014 and November 2015, 54 patients were transplanted during the study. Between listing and transplant, catch-up immunizations increased the patients' immunity from 70% to 87% (hepatitis A virus, P = .008), from 22% to 41% (hepatitis B virus, P = .008), from 77% to 91% (tetanus, P = .03), and from 78% to 98% (Streptococcus pneumoniae, P = .002). Their immunity at transplant was significantly higher against S. pneumoniae (P = .006) and slightly higher against hepatitis A virus (P = .07), but not against hepatitis B virus, than that of 65 SOT recipients transplanted in 2013. This demonstrates the value of a systematic multimodal serology-based approach of immunizations of SOT candidates at listing and the need for optimized strategies to increase their hepatitis B virus vaccine responses.
实体器官移植（SOT）候选者可能无法对潜在的可通过疫苗预防的疾病产生免疫，原因是免疫接种不足和/或疫苗应答有限。我们评估了在列出的情况下进行系统疫苗学检查对移植时疫苗免疫的影响，包括（1）有和没有流感的肺炎球菌免疫接种，（2）基于血清学的麻疹、水痘、乙型肝炎病毒、甲型肝炎病毒和破伤风疫苗建议，以及（3）在国家电子免疫登记处（www.myvaccines.ch）中记录疫苗和血清学测试。在 2014 年 1 月至 2015 年 11 月期间评估的 219 名 SOT 候选者中，有 54 名患者在研究期间接受了移植。在列出和移植之间，补种疫苗将患者的免疫力从 70%提高到 87%（甲型肝炎病毒，P=.008），从 22%提高到 41%（乙型肝炎病毒，P=.008），从 77%提高到 91%（破伤风，P=.03），从 78%提高到 98%（肺炎链球菌，P=.002）。他们在移植时对肺炎链球菌（P=.006）的免疫力明显更高，对甲型肝炎病毒（P=.07）的免疫力略高，但对乙型肝炎病毒的免疫力没有 2013 年接受移植的 65 名 SOT 受者高。这证明了在列出时对 SOT 候选者进行系统的多模式基于血清学的免疫接种方法的价值，并且需要优化策略来提高他们的乙型肝炎病毒疫苗应答。
