title: Immunization practices among pediatric transplant hepatologists.
abstract: Vaccination of pediatric liver transplant candidates and recipients represents an opportunity to decrease infectious complications following transplant. Although vaccine recommendations exist, studies have shown that many transplant candidates and recipients are under-immunized. The goals of this study were to assess among pediatric transplant hepatologists: (i) current immunization practices before and after transplantation, (ii) involvement of an ID physician in the transplant evaluation, and (iii) perceptions about vaccine safety and barriers to immunization. An 80-item e-mail survey of pediatric transplant hepatologists at centers in the United States and Canada participating in the SPLIT consortium was conducted from December 2014 to March 2015. The overall response rate was 80% (73/91), representing 97% (32/33) of SPLIT centers. Fifty percent of programs routinely involved an ID physician in the transplant evaluation. Administration of palivizumab was routinely considered by 48% of hepatologists pre-transplant and by 41% post-transplant. Live vaccines were recommended by 26% of hepatologists after transplant. About 10% of hepatologists reported concern that live vaccines after transplant could induce rejection. There is wide variation in immunization practices among transplant hepatologists. Specific evidence-based protocols are needed to guide immunization practices in transplant candidates and recipients.
authors.affiliation: Digestive Health Institute, Children's Hospital Colorado, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Feldman
authors.affiliation: Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Department of Pediatrics, Anschutz Medical Campus & Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
authors.affiliation: Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Anschutz Medical Campus & Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Beaty
authors.affiliation: Digestive Health Institute, Children's Hospital Colorado, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Shikha S
authors.initials: SS
authors.lastname: Sundaram
mesh_terms: D002170:Canada; D002648:Child; D019317:Evidence-Based Medicine; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D000069455:Palivizumab / Q000627:therapeutic use; D010372:Pediatrics / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States; D014612:Vaccines / Q000008:administration & dosage
chemical_list: D014612:Vaccines; D000069455:Palivizumab
keywords: immunizations; live vaccines; liver transplantation; vaccinations