Variability in immunization guidelines in children before and after lung transplantation.
Lung transplant candidates and recipients are at high risk of infections from vaccine-preventable diseases. However, well-established guidelines neither exist for pre- and post-transplant vaccination nor do monitoring guidelines for pediatric lung transplant recipients. To ascertain the current vaccination and monitoring practices of pediatric lung transplant centers, a self-administered questionnaire was distributed to the 18 pediatric lung transplant centers within the International Pediatric Lung Transplant Collaborative in April 2006. Sixteen of 18 centers (89%) surveyed responded. Pretransplant, national vaccination guidelines are followed. Eleven centers reported following standardized vaccination guidelines post-transplant. Vaccines were more commonly provided by the primary-care physician pretransplant (69%) rather than post-transplant (38%). Post-transplant, 50% of the centers recommend live vaccines for household contacts but not for the transplant recipient. Pretransplant monitoring of response to prior vaccination was performed inconsistently except for varicella (88%). Only 44% of the transplant centers measure for response to vaccination post-transplant, mostly hepatitis B. Current vaccination practices of pediatric lung transplant centers are heterogeneous. The lung transplant community would be well served by studies designed to evaluate the efficacy of vaccinations in this population.
Benden
Christian
C
Division of Pulmonary Medicine and Lung Transplantation, University Hospital, Zurich, Switzerland. christian_benden@yahoo.de
Danziger-Isakov
Lara A
LA
Astor
Todd
T
Aurora
Paul
P
Bluemchen
Katharina
K
Boyer
Debra
D
Conrad
Carol
C
Eichler
Irmgard
I
Elidemir
Okan
O
Goldfarb
Samuel
S
Michaels
Marian G
MG
Mogayzel
Peter J
PJ
Mueller
Carsten
C
Parakininkas
Daiva
D
Oberkfell
Donna
D
Solomon
Melinda
M
Boehler
Annette
A
D002170:Canada / Q000453:epidemiology; D002648:Child; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000592:standards*; D016040:Lung Transplantation / Q000379:methods*; D011182:Postoperative Care / Q000592:standards* / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000592:standards* / Q000639:trends; D012131:Respiratory Insufficiency / Q000601:surgery; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000592:standards*; D014612:Vaccines / Q000627:therapeutic use
D014612:Vaccines