title: Vaccinations, response, and controls before and after intestinal transplantation in children.
abstract: Vaccination is an effective strategy to decrease infections in transplant recipients. Children after intestinal transplantation carry a high risk of infection due to increased immunosuppression. In a series of 22 children after intestinal transplantation, we studied the vaccination schedules and the antibodies against vaccine-preventable diseases before transplantation, and at one and five yr after transplantation. We reviewed whether the vaccination schedules were complete, and we analysed the factors that may influence serological immunity and the incidence of disease in patients with deficient immunity. All patients completed the recommended vaccination schedules for DTaP-IPV and HBV. After transplantation, the negative antibodies against vaccine-preventable diseases were mostly related to an antirejection therapy: for DTaP-IPV: four of four patients with no antibody had been treated for rejection, for HBV: two of five, HAV: three of four, MMR: three of seven, and VZV: three of four. A post-transplantation varicella infection was followed by acute rejection, with probability for a relationship between both events. We observed 50% of varicella cases in unvaccinated children, highlighting the importance of pretransplant vaccination. Waning immunogenicity mediated by antibodies against vaccine-preventable disease after transplantation indicated a need for boosters. The recommendations should be regularly enforced, as the reliance on routine immunizations schedules is not adequate in immunocompromised patients.
authors: Pediatric Hepato-Gastro-Enterology-Nutrition Unit, Necker-Enfants Malades Hospital, Paris, France.
authors: Z
authors: Z
authors: Demir
authors: Microbiology Department, Necker-Enfants Malades Hospital, Paris, France.|Pediatric Immunology and Hematology Unit, Necker Hospital, Paris, France.|EA 7327, Paris Descartes University, Sorbonne Paris Cite, Paris, France.
authors: P
authors: P
authors: Frange
authors: Pediatric Hepato-Gastro-Enterology-Nutrition Unit, Necker-Enfants Malades Hospital, Paris, France.
authors: F
authors: F
authors: Lacaille
mesh_terms: D002644:Chickenpox / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004165:Diphtheria / Q000517:prevention & control; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006506:Hepatitis A / Q000517:prevention & control; D006509:Hepatitis B / Q000517:prevention & control; D006801:Humans; D007115:Immunization Schedule; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007410:Intestinal Diseases / Q000150:complications* / Q000601:surgery*; D007422:Intestines / Q000637:transplantation*; D008297:Male; D008457:Measles / Q000517:prevention & control; D009107:Mumps / Q000517:prevention & control; D011051:Poliomyelitis / Q000517:prevention & control; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage; D012409:Rubella / Q000517:prevention & control; D013742:Tetanus / Q000517:prevention & control; D014180:Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014611:Vaccination; D014917:Whooping Cough / Q000517:prevention & control
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D007166:Immunosuppressive Agents; D011054:Poliovirus Vaccine, Inactivated
keywords: immunosuppression; infection; intestinal transplantation; serological immunity; vaccination