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实体器官移植成年候选者及受者的疫苗接种建议

Vaccination Recommendations in Solid Organ Transplant Adult Candidates and Recipients.

作者信息

Viganò Mauro, Beretta Marta, Lepore Marta, Abete Raffaele, Benatti Simone Vasilij, Grassini Maria Vittoria, Camagni Stefania, Chiodini Greta, Vargiu Simone, Vittori Claudia, Iachini Marco, Terzi Amedeo, Neri Flavia, Pinelli Domenico, Casotti Valeria, Di Marco Fabiano, Ruggenenti Piero, Rizzi Marco, Colledan Michele, Fagiuoli Stefano

机构信息

Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy.

Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy.

出版信息

Vaccines (Basel). 2023 Oct 18;11(10):1611. doi: 10.3390/vaccines11101611.

Abstract

Prevention of infections is crucial in solid organ transplant (SOT) candidates and recipients. These patients are exposed to an increased infectious risk due to previous organ insufficiency and to pharmacologic immunosuppression. Besides infectious-related morbidity and mortality, this vulnerable group of patients is also exposed to the risk of acute decompensation and organ rejection or failure in the pre- and post-transplant period, respectively, since antimicrobial treatments are less effective than in the immunocompetent patients. Vaccination represents a major preventive measure against specific infectious risks in this population but as responses to vaccines are reduced, especially in the early post-transplant period or after treatment for rejection, an optimal vaccination status should be obtained prior to transplantation whenever possible. This review reports the currently available data on the indications and protocols of vaccination in SOT adult candidates and recipients.

摘要

预防感染对于实体器官移植(SOT)候选者和接受者至关重要。由于先前的器官功能不全和药物免疫抑制,这些患者面临的感染风险增加。除了与感染相关的发病率和死亡率外,这一弱势群体在移植前和移植后阶段还分别面临急性失代偿以及器官排斥或衰竭的风险,因为抗菌治疗在免疫功能正常的患者中比在这些患者中更有效。疫苗接种是针对该人群特定感染风险的主要预防措施,但由于对疫苗的反应会降低,尤其是在移植后早期或抗排斥治疗后,因此应尽可能在移植前获得最佳疫苗接种状态。本综述报告了目前关于SOT成年候选者和接受者疫苗接种指征和方案的可用数据。

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