title: Immune response to rabies vaccination in pediatric transplant patients.
abstract: Children have become engaged in a wider variety of activities as the success of solid organ transplantation has improved. These activities can result in exposure to infectious agents for which there are no data documenting the efficacy of standard treatment in children on immunosuppressive therapy. This is a retrospective review of five OLT patients and three RT patients who were potentially exposed to rabies during camp. They completed the immunoprophylaxis treatment for rabies exposure outlined by the CDC in the 2003 Red Book. Rabies titers were followed for six to 12 months post-immunization. All five OLT patients were on tacrolimus. All three RT patients were on tacrolimus, mycophenolate mofetil, and prednisone. At the time of exposure median age was 10.0 yr (8.4-17.3). None of the subjects developed rabies. A positive rabies titer, indicative of successful immunization, was present by one month in seven subjects and all subjects by six months. Rabies vaccination in pediatric transplant patients is safe and associated with the successful production of antirabies titers.
authors.affiliation: Pediatric Nephrology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55095, USA. cramer.carl@mayo.edu
authors.forename: Carl H
authors.initials: CH
authors.lastname: Cramer
authors.forename: Victoria
authors.initials: V
authors.lastname: Shieck
authors.forename: Susan E
authors.initials: SE
authors.lastname: Thomas
authors.forename: David B
authors.initials: DB
authors.lastname: Kershaw
authors.forename: John C
authors.initials: JC
authors.lastname: Magee
authors.forename: M James
authors.initials: MJ
authors.lastname: Lopez
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007107:Immune System / Q000502:physiology*; D007136:Immunoglobulins / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D011241:Prednisone / Q000008:administration & dosage; D011819:Rabies Vaccines / Q000009:adverse effects*; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D011819:Rabies Vaccines; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus