High-dose hepatitis B vaccine in patients waiting for lung transplantation.
OBJECTIVE
To increase the response rate to hepatitis B vaccine in patients awaiting lung transplantation.


METHODS
Historically controlled, open-label study.


METHODS
Lung transplant clinic at a university hospital.


METHODS
Twenty-seven consecutive individuals with end-stage pulmonary disease who were enrolled to accrue 15 subjects who would complete the vaccine series before transplantation; and 27 lung transplant recipients who were immunized with the conventional dose before the study and served as historical controls.


METHODS
Intramuscular injection of high-dose hepatitis B vaccine 40 microgram at 0, 1, and 6 months.


RESULTS
Hepatitis B surface antibody (anti-HBs) concentrations were measured 1-2 months after completing the high-dose series. Individuals with undetectable anti-HBs received additional vaccine to a maximum of six doses. The response rate to the series was compared with that in the control group. Seventeen individuals in the high-dose group and 14 controls met the study criterion of complete vaccine series before transplantation. The former had a much higher response rate than the latter (9 [53%] vs 1 [7%], p<0.01). Four of six patients who received additional doses of vaccine seroconverted. Two of them underwent transplantation shortly after completing the three-dose series.


CONCLUSIONS
The high-dose hepatitis B vaccine series produced a protective immune response in lung transplant recipients; however, the response was suboptimal, and alternative immunization strategies should be studied.
School of Pharmacy, University of Wisconsin, Madison 53705-2222, USA. mshayney@pharmacy.wisc.edu
Mary S
MS
Hayney
Deborah L
DL
Welter
Ann Marie
AM
Reynolds
Mary
M
Francois
Robert B
RB
Love
D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D016040:Lung Transplantation; D008297:Male
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines