Title: Assessing vaccine-induced immunity against pneumococcus, hepatitis A and B over a 9-year follow-up in pediatric liver transplant recipients: a nationwide retrospective study
Source: American Journal of Transplantation 2023, Dec 14. [E-publication]
Date of publication: December 2023
Publication type: Retrospective cohort study
Abstract: Pediatric liver transplant recipients are particularly at risk of infections. The most cost-effective way to prevent infectious complications is through vaccination, which can potentially prevent infections due to hepatitis B (HBV) virus, hepatitis A virus (HAV) and invasive pneumococcal diseases. Here, we performed a retrospective analysis of HBV, HAV and pneumococcal immunity in pediatric liver transplant recipients between Jan 1, 2009 and 31 Dec, 2020 to collect data on immunization and vaccine serology. Fifty-eight of 62 (94%) patients had available vaccination records. At transplant, 45/50 (90%) were seroprotected against HBV, 19/30 (63%) against HAV and 18/23 (78%) had pneumococcal immunity, but immunity against these three pathogens remained suboptimal during 9-year follow-up. A booster vaccine was administered to only 20-40% of patients. Children who had received >4 doses of HBV vaccine and >2 doses of HAV vaccine pre-transplant displayed a higher overall seroprotection over time post-SOT. Our findings suggest that a serology-based approach should be accompanied by a more systematic follow-up of vaccination, with special attention paid to patients with an incomplete vaccination status at time of transplant.
