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Humoral Immune Response following Seasonal Influenza Vaccine in Islet Transplant recipients

tetano

Editor, Senior Moderator
Cell Transplant. 2012 Sep 21. [Epub ahead of print]
Humoral Immune Response following Seasonal Influenza Vaccine in Islet Transplant recipients.
Silva M, Humar A, Shapiro AJ, Senior P, Hoschler K, Baluch A, Wilson LE, Kumar D.
Abstract

Introduction: Annual influenza vaccine is recommended for organ transplant recipients but immunogenicity is known to be sub-optimal. Islet transplant recipients receive immunosuppressive therapy but there are no data on the immunogenicity of influenza vaccine in this population.Methods: In this prospective cohort study, adult islet transplant recipients at least three months post-transplant were enrolled. All patients received the 2010-2011 seasonal influenza vaccine. Serum was obtained pre- and post-vaccination to determine humoral response to each of the three influenza strains included in the vaccine. Adverse effects of vaccine were also noted.Results: A total of 61 islet transplant recipients were enrolled and completed the study protocol. The median time from last transplant was 1.9 years (range 0.26-11.4 years) and most patients had undergone multiple prior islet transplant procedures (90.2%). Overall immunogenicity of the vaccine was poor. Seroconversion rates to H1N1, H3N2, and B antigens were 34.4%, 29.5%, and 9.8% respectively. In the subset not seroprotected at baseline, a protective antibody titer post-vaccination was achieved in 58.6%, 41.9%, and 34.5% of patients respectively. Patients within the first year of transplant were significantly less likely to seroconvert to at least one antigen (23.5% vs. 54.5%; p=0.029). Alemtuzumab recipients trended towards lower seroconversion rates (25% vs. 51%; p=0.11). No vaccinerelated safety concerns were identified.Conclusion: Seasonal influenza vaccine had suboptimal immunogenicity in islet transplant recipients especially those who were less than one year post-transplant or had received alemtuzumab induction. Novel strategies for protection in this group of patients need further study.

PMID:
23006439
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/23006439
 
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