Impact of squalene-based adjuvanted influenza vaccination on graft outcome in kidney transplant recipients.
BACKGROUND
Safety concerns have been raised about the use of adjuvanted vaccines after kidney transplantation.


METHODS
We retrospectively analyzed 65 kidney transplant (KT) recipients who received ≥1 dose of influenza vaccine (pandemic or seasonal) during the 2009-2010 campaign. Participants were classified into 2 groups: those who received a squalene-based AS03- or MF59-adjuvanted vaccine ("adjuvanted vaccination" [AV] group, n = 37) and those who exclusively received non-adjuvanted vaccines ("non-adjuvanted vaccination" [NAV] group, n = 28). Primary outcomes included occurrence of biopsy-proven acute graft rejection (BPAR) and graft function at months 6 and 12 after vaccination. Patients were followed up until graft loss, death, or October 2010.


RESULTS
Four episodes of BPAR occurred during post-vaccination follow-up, with no differences between the AV and NAV groups, in terms of cumulative incidence (5.4% vs. 7.1%, respectively; P = 0.581), incidence rate (0.22 vs. 0.18 episodes per 1000 transplant-days; P = 0.950), or occurrence of severe episodes (T-cell-mediated BPAR of grade ≥2a) (2.7% vs. 3.6%; P = 0.680). No between-group differences were seen in graft function after vaccination.


CONCLUSIONS
Adjuvanted influenza vaccination in KT recipients seems to be safe regarding graft outcome.
Unit of Infectious Diseases, Hospital Universitario "12 de Octubre" Instituto de Investigación Hospital "12 de Octubre" (i + 12), School of Medicine, Universidad Complutense, Madrid, Spain.
M
M
Fernández-Ruiz
C
C
Lumbreras
M P
MP
Arrazola
F
F
López-Medrano
A
A
Andrés
J M
JM
Morales
J R
JR
de Juanes
J M
JM
Aguado
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013185:Squalene / Q000627:therapeutic use*; D066027:Transplant Recipients
D000276:Adjuvants, Immunologic; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D013185:Squalene
adjuvanted vaccine; graft rejection; influenza vaccination; kidney transplantation; safety