title: Successful hepatitis B vaccination in liver transplant recipients with donor-specific hyporesponsiveness.
abstract: Currently, patients are prescribed lifelong treatment with hepatitis B immunoglobulin (HBIg) after liver transplantation (LT) for hepatitis B virus (HBV)-related diseases in order to prevent reinfection with HBV. Active immunization with an HBV vaccine would be a preferable alternative; however, the immunosuppressive environment in LT recipients is believed to elicit a poor response to vaccination. Minimizing the exposure of the HBV-infected LT recipients to immunosuppressants would be beneficial in inducing adaptive immunity against HBV by vaccination. In this study, in addition to efforts to minimize immunosuppression, prophylaxis with HBV vaccination combined with continuous HBIg administration was performed in 17 LT recipients who had undergone transplantation attributable to HBV-related diseases. During the observation period, the overall response rate to HBV vaccination was 64.7%. The immune status of the recipients was evaluated by a mixed lymphocyte reaction assay in response to allostimulation. Patients showing a donor-specific hyporesponse with a well-maintained response to the third-party stimulus always achieved a sustained immune response to the vaccine, whereas patients showing a hyporesponse to both the donor and the third-party stimulus were unable to do so. Thus, inducing an anti-donor-specific immunosuppressive status by minimizing immunosuppression should enable post-transplant HBV vaccination to be a promising prophylactic strategy.
authors.affiliation: Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tahara
authors.forename: Yuka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ide
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shishida
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Irei
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ushitora
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.forename: Masataka
authors.initials: M
authors.lastname: Banshodani
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itamoto
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Asahara
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007116:Immunization, Passive; D007117:Immunization, Secondary; D007136:Immunoglobulins / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D014611:Vaccination
chemical_list: D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin