Failure of hepatitis B immunization in liver transplant recipients: results of a prospective trial.
Twenty patients with advanced liver disease, in need of transplantation, were given three injections of 20 micrograms and three injections of 40 micrograms hepatitis B vaccine to see if an antibody response could be obtained. Only 20% of patients developed measurable anti-HBs. One who failed to develop anti-HBs developed chronic hepatitis B after exposure to her infected sexual partner. Type of liver disease in the native liver, age, sex, sexual preference, timing of immunization (before or after transplantation), and dosage of hepatitis B vaccine did not seem to explain the lack of immunologic response to hepatitis B vaccine. It is presumed that immunosuppression, both from the underlying disease and from immunosuppressive medications, best explains our findings. Liver transplantation patients infrequently benefit from hepatitis B vaccine. It is possible that other vaccines given to prevent viral and bacterial illness may also fail to elicit immunologic response in such patients.
Carey
W
W
Department of Gastroenterology, Cleveland Clinic, Ohio.
Pimentel
R
R
Westveer
M K
MK
Vogt
D
D
Broughan
T
T
D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage / Q000627:therapeutic use*
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D014761:Viral Hepatitis Vaccines