Attenuated varicella virus vaccine in children with renal transplants

Zamora, I.; Simón, J.M. Serrano; Silva, Maria E. Da; Piqueras, Ana Isabel

doi:10.1007/bf00865476

Cited by 176 publications

(112 citation statements)

References 15 publications

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“…Varicella vaccine was given to 17 pediatric renal patients and resulted in one case of mild varicella at 2 weeks and three additional cases after 2 to 4 years. Antibody response was 76%, but response was delayed (103). Concerns about the use of the vaccine in immunosuppressed patients have been raised and include the possibility of reactivation of the Oka strain (67), transmission of vaccine virus to the general population and development of zoster (46).…”

Section: Live Vaccinesmentioning

confidence: 99%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population

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Section: Live Vaccinesmentioning

confidence: 99%

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Duchini¹,

Goss²,

et al. 2003

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“…Most importantly, live vaccines should be avoided (oral polio, varicella, yellow fever, oral typhoid, bacillus Calmette-Guérin, and intranasal influenza vaccine). Although some small studies indicate that measles, mumps, and rubella and varicella vaccines may be safe after transplantation, 108,109 the American Academy of Pediatrics recommendation is to not administer live vaccines to immunosuppressed children. In addition, protective antibody titers may be low.…”

Section: Prevention Of Infectionmentioning

confidence: 99%

Management of the pediatric liver transplant patient

McDiarmid

2001

Liver Transplantation

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Key Points 1. In pretransplant management, the prevention and treatment of malnutrition is essential for pediatric patients as malnutrition is associated with both increased pre-and posttransplant mortality. 2. Technical complications, particularly hepatic artery thrombosis, after pediatric liver transplantation are relatively common given the small size of the majority of the recipients. Early recognition is essential to reduce the associated increased risk for both patient and graft loss. 3. Immunosuppression regimens in children should aim to begin weaning of steroids within the first year after transplant because of their detrimental impact on growth. 4. Long-term immunosuppression strategies must focus on avoiding the risks of long-term immunosuppression, particularly nephrotoxicity, neurotoxicity, de novo malignancy, and late infections. 5. EBV-associated PTLD is a special problem for young pediatric liver recipients. Strategies for prevention and preemptive management are essential. 6. Noncompliance in teens is a particular problem and is associated not only with graft dysfunction, but also with graft loss and patient death. Recognizing teens at risk and providing intervention strategies require a multi-disciplinary approach. (Liver Transpl 2001;7:S77-S86.)

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“…A more comparable study in terms of laboratory methods is a study in Spain of 34 children receiving either renal dialysis or posttransplantation, where 85% had antibodies detected by ELISA after one dose and 10% developed a rash (15). Compared with this study, the response in the children with juvenile rheumatic diseases may be lower.…”

mentioning

confidence: 75%