title: Timing of Haemophilus influenzae type b vaccination after cardiac surgery.
abstract: BACKGROUND
  The best time for vaccination in infants with congenital heart disease (CHD) after cardiopulmonary bypass (CPB) surgery is unclear, but it is important to prevent Haemophilus influenzae type b (Hib) infection in infants with CHD after CPB surgery. To identify the best time for Hib vaccination in infants with CHD after CPB surgery, we investigated the immunological status, and the efficacy and safety of Hib vaccination after CPB surgery.
  
  
  METHODS
  Sixteen subjects who underwent surgical correction of ventricular septal defect with CPB were investigated. Immunological status and cytokines were analyzed before surgery, 2 months after surgery, and before Hib booster vaccination. Hib-specific IgG was also measured to evaluate the effectiveness of vaccination.
  
  
  RESULTS
  Immunological status before and 2 months after surgery (e.g. whole blood cells and lymphocyte subset profile) was within the normal range and no subjects had hypercytokinemia. Additionally, all subjects who received Hib vaccination at 2-3 months after CPB surgery had effective serum Hib-specific IgG level for protection against Hib infection without any side-effects.
  
  
  CONCLUSIONS
  CPB surgery does not influence acquired immunity and Hib vaccination may be immunologically safe to perform at 2 months after CPB surgery. Hib vaccination at 2-3 months after CPB surgery was effective in achieving immunization for infants with simple left-right shunt-type CHD.
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Takanashi
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Ogata
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Honda
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nomoto
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Mineo
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kitagawa
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ando
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Sumito
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nakahata
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Oka
authors.affiliation: Department of Cardiovascular Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Kagami
authors.initials: K
authors.lastname: Miyaji
authors.affiliation: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishii
mesh_terms: D006348:Cardiac Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006192:Haemophilus Infections / Q000276:immunology / Q000517:prevention & control*; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007113:Immunity, Innate; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014611:Vaccination
keywords: Haemophilus influenzae type b; cardiopulmonary bypass; congenital heart disease; immunological status; vaccination