title: A cross-sectional study of tetanus and diphtheria antibody concentrations post vaccination among lung transplant patients compared with healthy individuals.
abstract: BACKGROUND
  Lung transplant (LuTx) patients are routinely immunized against tetanus and diphtheria. However, few studies have been done to measure serologic immunity in the transplant population.
  
  
  OBJECTIVE
  The primary objective of this study was to compare tetanus and diphtheria antibody concentrations in LuTx vs. healthy subjects.
  
  
  METHODS
  Serum was used from an available sample of 111 total individuals (n = 36 healthy; n = 75 LuTx). Tetanus and diphtheria antibody concentrations were measured using an enzyme-linked immunosorbant assay method.
  
  
  RESULTS
  A statistically significant difference in both tetanus and diphtheria antibody concentrations was found between the groups. The median concentration of tetanus antibody was higher for healthy individuals compared with the LuTx group (3.2 IU/mL [1.2-5.2 interquartile range {IQR}] vs. 1.3 IU/mL [0.4-2.6 IQR], respectively; P = 0.0001). No difference in time was found since the last tetanus-diphtheria vaccine or tetanus-diphtheria-pertussis vaccine dose between the groups (healthy 76.5 months [16-114 IQR] vs. LuTx 74.5 months [45-118 IQR]; P = 0.44).
  
  
  CONCLUSIONS
  Tetanus and diphtheria immunizations are recommended for LuTx patients to reduce the risk of infection. Because the LuTx group has lower antibody concentrations, further studies should investigate the possible need for more frequent tetanus and diphtheria boosters.
authors.affiliation: School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Rohde
authors.forename: K C
authors.initials: KC
authors.lastname: Cunningham
authors.forename: K M
authors.initials: KM
authors.lastname: Henriquez
authors.forename: A R
authors.initials: AR
authors.lastname: Nielsen
authors.forename: S L
authors.initials: SL
authors.lastname: Worzella
authors.forename: M S
authors.initials: MS
authors.lastname: Hayney
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000276:immunology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004165:Diphtheria / Q000517:prevention & control*; D022422:Diphtheria-Tetanus Vaccine / Q000276:immunology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D013742:Tetanus / Q000517:prevention & control*
chemical_list: D000907:Antibodies, Bacterial; D022422:Diphtheria-Tetanus Vaccine; D007166:Immunosuppressive Agents
keywords: antibody response; diphtheria vaccine; lung transplantation; seroprotection; tetanus vaccine