title: De novo anti-HLA antibody after pandemic H1N1 and seasonal influenza immunization in kidney transplant recipients.
abstract: In solid organ transplanted patients, annual influenza immunization is strongly recommended because of morbidity and mortality of influenza infections. In 2009, the rapid spread of a novel H1N1 influenza A virus led to the accelerated development of novel pandemic influenza vaccines. In Switzerland, the recipients received one dose of seasonal influenza and two doses of AS03-adjuvanted H1N1 vaccines. This situation provided a unique opportunity to analyze the influence of novel adjuvanted influenza vaccines on the production of de novo anti-HLA antibodies. We prospectively followed two independent cohorts including 92 and 59 kidney-transplanted patients, assessing their anti-HLA antibodies before, 6 weeks and 6 months after vaccination. Sixteen of 92 (17.3%) and 7 of 59 (11.9%) patients developed anti-HLA antibodies. These antibodies, detected using the single antigen beads technology, were mostly at low levels and included both donor-specific and non-donor-specific antibodies. In 2 of the 20 patients who were followed at 6 months, clinical events possibly related to de novo anti-HLA antibodies were observed. In conclusion, multiple doses of influenza vaccine may lead to the production of anti-HLA antibodies in a significant proportion of kidney transplant recipients. The long-term clinical significance of these results remains to be addressed.
authors.affiliation: Service of Nephrology, Department of Medicine, University Hospitals of Geneva, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Katerinis
authors.forename: K
authors.initials: K
authors.lastname: Hadaya
authors.forename: R
authors.initials: R
authors.lastname: Duquesnoy
authors.forename: S
authors.initials: S
authors.lastname: Ferrari-Lacraz
authors.forename: S
authors.initials: S
authors.lastname: Meier
authors.forename: C
authors.initials: C
authors.lastname: van Delden
authors.forename: P-Y
authors.initials: PY
authors.lastname: Martin
authors.forename: C-A
authors.initials: CA
authors.lastname: Siegrist
authors.forename: J
authors.initials: J
authors.lastname: Villard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000276:immunology*; D015331:Cohort Studies; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012621:Seasons
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; D007252:Influenza Vaccines