Article: article from journal or magazin.
Varicella-zoster immunization in pediatric liver transplant recipients: safe and immunogenic.
American Journal of Transplantation
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Varicella can have a severe course in immunosuppressed patients. Although prevention is fundamental, live-attenuated varicella-zoster (VZV) vaccine is not currently recommended in transplant recipients. Our aims were to (1) evaluate VZV immunity in pediatric liver transplant (LT) recipients; (2) immunize (two doses) seronegative patients post-LT; (3) monitor vaccine safety, (4) assess B and T cell vaccine responses. All patients followed at the Swiss National Pediatric LT Center were approached and 77/79 (97.5%) were enrolled (median age 7.8 years). Vaccine safety was monitored by standardized diary cards and phone calls. VZV-specific serology and CD4(+) T cells were assessed before and after immunization. Thirty-nine patients (51.1%) were seronegative including 14 children immunized pre-LT. Thirty-six of 39 seronegative patients were immunized post-LT (median 3.0 years post LT). Local (54.8%) and systemic (64.5%) reactions were mild and transient. The frequency of VZV-specific CD4(+) T cells and antibody titers increased significantly (respectively from 0.085% to 0.16%, p = 0.04 and 21.0 to 1134.5 IU/L, p < 0.001). All children reached seroprotective titers and 31/32 (97%) patients assessed remained seroprotected at follow-up (median 1.7 years). No breakthrough disease was reported during follow-up (median 4.1 years). Thereby, VZV vaccine appears to be safe, immunogenic and provide protection against disease in pediatric LT patients.
Antibodies, Viral/immunology, Chickenpox/immunology, Chickenpox/prevention & control, Chickenpox Vaccine/administration & dosage, Child, Child, Preschool, Female, Follow-Up Studies, Graft Rejection/prevention & control, Graft Survival, Herpes Zoster/immunology, Herpes Zoster/prevention & control, Herpes Zoster Vaccine/administration & dosage, Humans, Immunization/methods, Immunocompromised Host/immunology, Infant, Liver Transplantation/adverse effects, Liver Transplantation/methods, Male, Retrospective Studies, Risk Assessment, Safety Management, Transplantation Immunology, Treatment Outcome
Web of science
Last modification date