title: Successful serology-based intervention to increase protection against vaccine-preventable diseases in liver-transplanted children: a 19-yr review of the Swiss national reference center.
abstract: As children referred for OLT in Switzerland were not vaccinated optimally, new guidelines were developed and recommended to base catch-up immunization on serum antibody titers against vaccine-preventable diseases, before and after OLT. We measure the results of this serology-based intervention by comparing vaccine coverage and antibody titers in the pre- (1990-2002, P1) and post-intervention (2003-2008, P2) cohorts in a quality control project. Forty-four P1 and 30 P2 children were evaluated. At pre-OLT visit, D, T, SPn, and MMR serologies were checked more frequently in P2 than P1 (p < 0.05). More P2 children were up-to-date for DTaP and MMR (p < 0.05) or had received ≥1 dose of HBV, HAV, SPn, and VZV vaccines (p < 0.05). One yr post-OLT, DT, SPn, MMR, and VZV serologies were more frequently checked (p < 0.05), and antibody titers were higher for DT and HAV (p < 0.05) in P2. Gender, age, or diagnosis did not explain these differences. Among P2 patients, pre- and post-OLT titers for D, T, Hib, HBV, SPn14, and SPn19 were correlated (p < 0.05 for all). Protection against vaccine-preventable diseases of high-risk children like OLT patients can be significantly improved by serology-based intervention for vaccine-preventable diseases.
authors.affiliation: Department of Pediatrics, University Hospitals of Geneva, Switzerland.
authors.forename: A G
authors.initials: AG
authors.lastname: L'Huillier
authors.forename: B E
authors.initials: BE
authors.lastname: Wildhaber
authors.forename: D C
authors.initials: DC
authors.lastname: Belli
authors.forename: A
authors.initials: A
authors.lastname: Diana
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: C A
authors.initials: CA
authors.lastname: Siegrist
authors.forename: K M
authors.initials: KM
authors.lastname: Posfay-Barbe
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003140:Communicable Disease Control; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D017093:Liver Failure / Q000097:blood / Q000150:complications* / Q000821:virology; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011786:Quality Control; D012042:Registries; D012699:Serology / Q000379:methods; D013557:Switzerland; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods; D014612:Vaccines / Q000627:therapeutic use*; D014777:Virus Diseases / Q000150:complications / Q000517:prevention & control*
chemical_list: D014612:Vaccines