Antibody response to influenza immunization in kidney transplant recipients receiving either azathioprine or mycophenolate: a controlled trial.
OBJECTIVE
We aimed to assess humoral immune response to the influenza vaccine in adult kidney transplant recipients (KTRs) subjected to two immunosuppressive regimens containing either mycophenolate mofetil (MMF) or azathioprine (Aza).


METHODS
40 eligible KTRs (24 treated with Aza [KTRs-Aza] and 16 treated with MMF [KTRs-MMF]) and 40 matched healthy controls (HCs) were administered the trivalent 2006-2007 anti-influenza vaccine. Antibody (Ab) titers were measured before (pre-vacc) and 1 month after (post-vacc) vaccination. The proportion of protective Ab titers (i.e. >or=1:40), the serological response (i.e. >or=4-fold rise in titers) rates, and the magnitudes of change in titers were evaluated.


RESULTS
KTRs and HCs were similar in serologic responses, magnitudes of change in Ab titers, and proportions of acquired protective titers against all antigens. Whereas KTRs-MMF and KTRs-Aza were identical in magnitude of rise in titers as well as in serologic responses, KTRs-MMF did poorer in developing post-vacc-protective titers against A/H1N1 (p < 0.05). The function of the transplanted kidney has not deteriorated after vaccination.


CONCLUSIONS
Anti-influenza vaccination was safe in KTRs and evoked Ab responses comparable to those of HCs. KTRs-MMF and KTRs-Aza responded almost equally to the vaccine. Annual anti-influenza vaccination can be recommended to all stable KTRs.
Keshtkar-Jahromi
Maryam
M
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University MC, Tehran, Iran. maryam_keshtkar@yahoo.com
Argani
Hassan
H
Rahnavardi
Mohammad
M
Mirchi
Elham
E
Atabak
Shahnaz
S
Tara
Seied Ahmad
SA
Gachkar
Latif
L
Noori-Froothghe
Azam
A
Mokhtari-Azad
Talat
T
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000917:Antibody Formation / Q000187:drug effects*; D001379:Azathioprine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000494:pharmacology* / Q000627:therapeutic use; D014611:Vaccination
D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D009173:Mycophenolic Acid; D001379:Azathioprine