Immunizations in solid organ and hematopoeitic stem cell transplant patients: A comprehensive review.
The Solid Organ Transplantation (SOT) and Haematopoietic Stem Cell Transplantation (HSCT) population is continuously increasing as a result of broader indications for transplant and improved survival. Infectious diseases, including vaccine-preventable diseases, are a significant threat for this population, primarily after but also prior to transplantation. As a consequence, clinicians must ensure that patients are optimally immunized before transplantation, to provide the best protection during the early post-transplantation period, when immunosuppression is the strongest and vaccine responses are poor. After 3-6 months, inactivated vaccines immunization can be resumed. By contrast, live-attenuated vaccines are lifelong contraindicated in SOT patients, but can be considered in HSCT patients at least 2 years after transplantation, if there is no immunosuppression or graft-versus-host-disease. However, because of the advantages of live-attenuated over inactivated vaccines--and also sometimes the absence of an inactivated alternative--an increasing number of prospective studies on live vaccine immunization after transplantation are performed and give new insights about safety and immunogenicity in this population.
a Pediatric Infectious Diseases Unit, Department of Pediatrics; University Hospitals of Geneva & Geneva Medical School , Geneva , Switzerland ;
Arnaud G
AG
L'Huillier
b Transplant Infectious Diseases and Multi-Organ Transplant Program; University Health Network ; Toronto , Ontario , Canada.
Deepali
D
Kumar
D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D016377:Organ Transplantation; D066027:Transplant Recipients; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000276:immunology; D015164:Vaccines, Inactivated / Q000276:immunology; D014765:Viral Vaccines / Q000276:immunology
D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated; D014765:Viral Vaccines
Haematopoietic stem cell transplantation; graft versus host disease; immunogenicity; immunosuppression; safety; serology; solid organ transplantation; vaccine