Response to hepatitis B vaccination by liver transplant candidates.
Liver transplantation (OLTx) is a procedure offered to individuals with advanced liver disease who are expected to live less than a year. Despite improvement in the care of transplant recipients, these patients are exposed to large volumes of blood and, as a result, are at risk to acquire hepatitis. Currently, the only vaccines available for the prevention of hepatitis are those that induce a response to HBsAg. In this study, 144 patients awaiting OLTx and 15 controls were vaccinated three times, once a month, intramuscularly in the deltoid using the Merck Hepatovax plasma-derived vaccine. This schedule was continued regardless of whether or not OLTx occurred before the series was completed. For the 15 controls, the response rate was 93% and for individuals with end-stage liver disease, it ranged from 44 to 54% (P less than 0.004). No difference in the percentage of those developing antibody was detected between groups based upon disease indication or whether the vaccination series was completed before or after OLTx. Of the following: WBC, lymphocytes (percent and number), CD3+ cells (percent and number), CD4+ cells (percent and number), CD8+ cells (percent and number), CD4+/CD8+ ratio, and B cells (percent and number), only the absolute WBC (P less than 0.05) distinguished between those who did and did not develop antibody.(ABSTRACT TRUNCATED AT 250 WORDS)
Van Thiel
D H
DH
Department of Surgery, Graduate School of Public Health, University of Pittsburgh School of Medicine, Pennsylvania 15261.
el-Ashmawy
L
L
Love
K
K
Gavaler
J S
JS
Starzl
T E
TE
D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007115:Immunization Schedule; D008107:Liver Diseases / Q000145:classification / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology* / Q000706:statistics & numerical data; D008875:Middle Aged; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D014761:Viral Hepatitis Vaccines