tetano
Editor, Senior Moderator
Clin Res Hepatol Gastroenterol. 2019 Oct 10. pii: S2210-7401(19)30191-3. doi: 10.1016/j.clinre.2019.08.007. [Epub ahead of print] [h=1]Vaccination in adult liver transplantation candidates and recipients.[/h]
Valour F[SUP]1[/SUP], Conrad A[SUP]1[/SUP], Ader F[SUP]1[/SUP], Launay O[SUP]2[/SUP].
[h=3]Author information[/h] 1 Service des maladies infectieuses et tropicales, Hospices Civils de Lyon, 69004 Lyon, France; Centre International de Recherche en Infectiologie, Inserm, U1111, Universit? Claude-Bernard Lyon 1, CNRS, UMR5308, ?cole Normale Sup?rieure de Lyon, Univ Lyon, 69007, Lyon, France; Universit? Claude-Bernard Lyon 1, 69008 Lyon, France. 2 Inserm, CIC 1417, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75014 Paris, France; Universit? de Paris, 75014 Paris, France; Assistance Publique-H?pitaux de Paris, CIC Cochin Pasteur, H?pital Cochin Paris, 75014 Paris, France. Electronic address: odile.launay@aphp.fr.
[h=3]Abstract[/h] In patients with chronic liver disease and liver transplant recipients, cirrhosis-associated immune dysfunction syndrome and immunosuppressant drug regimens required to prevent graft rejection lead to a high risk of severe infections, associated with acute liver decompensation, graft loss and increased mortality. In addition to maintain their global health status, vaccination represents a major preventive measure against specific infectious risks of particular concern in this population, such as invasive pneumococcal diseases, influenza or viral hepatitis A and B. However, immunization in this setting raises several issues: i) recommended vaccination schedules rely on sparse immunogenicity data without clinical efficacy and effectiveness trials designed for this specific population; ii) dynamics of immunosuppression makes timing of immunization challenging; iii) live attenuated vaccines are contraindicated after transplantation; and iv) vaccines tolerance is poorly known in cirrhotic patients. This review outlines the rational for vaccination in adult liver transplant candidates and recipients and available data regarding immunization in this specific population.
Copyright ? 2019 Elsevier Masson SAS. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Invasive pneumococcal disease; Liver transplantation; Vaccination; Viral hepatitis A; Viral hepatitis B
PMID: 31607643 DOI: 10.1016/j.clinre.2019.08.007
Valour F[SUP]1[/SUP], Conrad A[SUP]1[/SUP], Ader F[SUP]1[/SUP], Launay O[SUP]2[/SUP].
[h=3]Author information[/h] 1 Service des maladies infectieuses et tropicales, Hospices Civils de Lyon, 69004 Lyon, France; Centre International de Recherche en Infectiologie, Inserm, U1111, Universit? Claude-Bernard Lyon 1, CNRS, UMR5308, ?cole Normale Sup?rieure de Lyon, Univ Lyon, 69007, Lyon, France; Universit? Claude-Bernard Lyon 1, 69008 Lyon, France. 2 Inserm, CIC 1417, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75014 Paris, France; Universit? de Paris, 75014 Paris, France; Assistance Publique-H?pitaux de Paris, CIC Cochin Pasteur, H?pital Cochin Paris, 75014 Paris, France. Electronic address: odile.launay@aphp.fr.
[h=3]Abstract[/h] In patients with chronic liver disease and liver transplant recipients, cirrhosis-associated immune dysfunction syndrome and immunosuppressant drug regimens required to prevent graft rejection lead to a high risk of severe infections, associated with acute liver decompensation, graft loss and increased mortality. In addition to maintain their global health status, vaccination represents a major preventive measure against specific infectious risks of particular concern in this population, such as invasive pneumococcal diseases, influenza or viral hepatitis A and B. However, immunization in this setting raises several issues: i) recommended vaccination schedules rely on sparse immunogenicity data without clinical efficacy and effectiveness trials designed for this specific population; ii) dynamics of immunosuppression makes timing of immunization challenging; iii) live attenuated vaccines are contraindicated after transplantation; and iv) vaccines tolerance is poorly known in cirrhotic patients. This review outlines the rational for vaccination in adult liver transplant candidates and recipients and available data regarding immunization in this specific population.
Copyright ? 2019 Elsevier Masson SAS. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Invasive pneumococcal disease; Liver transplantation; Vaccination; Viral hepatitis A; Viral hepatitis B
PMID: 31607643 DOI: 10.1016/j.clinre.2019.08.007