Influenza vaccination in orthotopic liver transplant recipients: absence of post administration ALT elevation.
Influenza vaccination has reduced life-threatening complications from influenza virus infection in adult liver transplant recipients. We evaluated changes in aminotransferase level and immunogenicity of influenza vaccination in liver transplant recipients. Fifty-one liver transplant recipients were administered a standard dose of the 2002-2003 inactivated trivalent influenza vaccine. ALT values were measured at baseline, 1 week and 4-6 weeks postvaccination. Antibody responses to each component of the vaccine were measured at baseline and after 4-6 weeks by a hemagglutination inhibition (HAI) assay. Response was defined as an HAI titer > or = 1: 40 and/or a 4-fold increase in antibody titers from baseline. An ALT elevation was defined as a rise of > or = 50% from baseline. There was no difference in the median rise in ALT value between seroconverters and nonseroconverters. A significant number of recipients developed potentially protective antibody titers (p-value < 0.0001). At less than 4 months post transplantation, 1/7 (14%), at 4-12 months, 6/9 (67%), and after 12 months, 30/35 (86%) subjects responded to the H1 strain. Of 51 recipients, one HCV (-) recipients vaccinated within 3 months of transplantation developed acute cellular rejection. Influenza virus vaccination is not associated with allograft rejection or ALT flares in liver transplant recipients.
Department of Medicine and Division of Liver Diseases, The Mount Sinai Medical Center, New York, NY, USA.
Adeyemi
A
Lawal
Chris
C
Basler
Andrea
A
Branch
Julio
J
Gutierrez
Myron
M
Schwartz
Thomas D
TD
Schiano
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000419:Albuminuria; D000469:Alkaline Phosphatase / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000209:etiology; D006385:Hemagglutination Inhibition Tests; D006526:Hepatitis C / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007252:Influenza Vaccines / Q000009:adverse effects; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis
D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D012709:Serum Albumin; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase