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成人心脏和肺移植受者移植前疫苗接种的依从性。

Pre-transplant vaccination compliance in adult heart and lung transplant recipients.

机构信息

Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.

Department of Infectious Diseases, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Clin Transplant. 2021 Nov;35(11):e14464. doi: 10.1111/ctr.14464. Epub 2021 Sep 16.

Abstract

BACKGROUND

Vaccine preventable diseases can affect solid organ transplant recipients post-transplant. Therefore, the administration of vaccines and assessment of serologic response should be prioritized in the pre-transplant period.

METHODS

This single-center, retrospective study included 349 adult heart or lung transplant candidates between December 1, 2017 and November 30, 2019. We describe vaccination or serologic status for hepatitis A, hepatitis B, tetanus, pneumococcal, influenza, and other recommended vaccinations among heart or lung transplant candidates.

RESULTS

Eighty-two heart transplant candidates (91%) and 77 lung transplant candidates (30%) received an ID consult prior to transplant. More patients completed the pneumococcal series (66.7% vs. 28.6%, P = .045) in the heart transplant group that received an ID consult. In the lung transplant group, patients with an ID consult demonstrated higher rates of immunity to hepatitis A (84.4% vs. 72.9%, P = .047), hepatitis B (75.3% vs. 56.9%, P = .005), and measles (71.4% vs. 52.5%, P = .005) compared to those without.

CONCLUSIONS

Our results demonstrate the value of consulting ID and administering vaccinations in the early evaluation phase, prior to transplant listing. Opportunities remain to better optimize vaccination rates prior to transplant in heart and lung transplant candidates.

摘要

背景

疫苗可预防的疾病会影响移植后的实体器官移植受者。因此,应在移植前优先考虑疫苗接种和血清学反应评估。

方法

这项单中心回顾性研究纳入了 2017 年 12 月 1 日至 2019 年 11 月 30 日期间的 349 例成年心脏或肺移植候选者。我们描述了心脏或肺移植候选者中甲型肝炎、乙型肝炎、破伤风、肺炎球菌、流感和其他推荐疫苗的接种或血清学状态。

结果

82 例心脏移植候选者(91%)和 77 例肺移植候选者(30%)在移植前接受了 ID 咨询。在接受 ID 咨询的心脏移植组中,更多的患者完成了肺炎球菌系列疫苗接种(66.7%比 28.6%,P=0.045)。在肺移植组中,接受 ID 咨询的患者对甲型肝炎(84.4%比 72.9%,P=0.047)、乙型肝炎(75.3%比 56.9%,P=0.005)和麻疹(71.4%比 52.5%,P=0.005)的免疫率更高。

结论

我们的研究结果表明,在移植前列出名单之前,咨询 ID 和接种疫苗在早期评估阶段具有重要价值。在心脏和肺移植候选者中,在移植前优化疫苗接种率仍有机会。

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