title: Influenza vaccination is efficacious and safe in renal transplant recipients.
abstract: Whether influenza vaccination in solid-organ transplant recipients is efficacious remains a controversial issue. Furthermore, theoretical concerns have been raised regarding the safety of vaccination as it might trigger rejection of the allograft. The present prospective trial is aimed at investigating the antibody response and safety of influenza vaccination in renal transplant recipients (RTR). A total of 165 RTR and 41 healthy volunteers were vaccinated with a standard trivalent inactivated influenza vaccine. Hemagglutination-inhibiting (HI) antibodies were quantified before and 1 month after vaccination. Seroprotection (SP) and seroresponse (SR) were defined as a titer > or =40 and a 4-fold rise in HI titer, respectively. Similar SR rates were observed in both groups. Postvaccination SP rates in RTR amounted to 92.7%, 78.7% and 82.9% for A/H1N1, A/H3N2 and B, respectively. High baseline SP rates, most probably reflecting frequent preimmunizations, explain partly the high postvaccination SP rates. SR rate was independently and inversely associated with baseline SP rate. Mycophenolate mofetil (MMF) usage was associated with a 2.6-5-fold lower SR. Nonetheless, these patients showed good postvaccination SP rates. A booster dose did not enhance SP or SR rates. Influenza vaccination neither affected allograft function nor caused rejection episodes. In conclusion, influenza vaccination is efficacious and safe in renal transplantation.
authors.affiliation: Division of Nephrology, Department of Medicine, University Hospital Gasthuisberg, B-3000 Leuven, Belgium. johan.scharpe@gza.be
authors.forename: J
authors.initials: J
authors.lastname: Scharpé
authors.forename: P
authors.initials: P
authors.lastname: Evenepoel
authors.forename: B
authors.initials: B
authors.lastname: Maes
authors.forename: B
authors.initials: B
authors.lastname: Bammens
authors.forename: K
authors.initials: K
authors.lastname: Claes
authors.forename: A D
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: Y
authors.initials: Y
authors.lastname: Vanrenterghem
authors.forename: W E
authors.initials: WE
authors.lastname: Peetermans
mesh_terms: D000328:Adult; D000917:Antibody Formation; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012449:Safety
chemical_list: D007252:Influenza Vaccines; D003404:Creatinine