Humoral and Cellular Immune Responses after Influenza Vaccination in Kidney Transplant Recipients

Candon, Sophie; Thervet, Éric; Lebon, Pierre; Suberbielle, Caroline; Zuber, Julien; Lima, Carla Laíne Silva; Charron, Dominique; Legendre, Christophe; Chatenoud, Lucienne

doi:10.1111/j.1600-6143.2009.02787.x

Cited by 109 publications

(99 citation statements)

References 44 publications

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“…This observation is similar to previous reports pertaining to influenza vaccination (9,11,26). This work brings additional data supporting the safety of influenza vaccination in renal transplant recipients (8,33) and also documents that vaccination does not induce sensitization against HLA or MICA in dialyzed patients, who can become candidates for kidney transplantation. De novo HLA sensitization was recorded in only two patients (1.1%), a proportion even lower than the 4.8% reported by Candon et al (8).…”

Section: Discussionsupporting

confidence: 78%

“…De novo HLA sensitization was recorded in only two patients (1.1%), a proportion even lower than the 4.8% reported by Candon et al (8). Our findings are in line with other recent publications that did not report an increase in acute rejection rates triggered by vaccination (8,9,34). Similar to HLA sensitization, the prevalence of MICA Abs remained stable after vaccination, and the frequency of de novo MICA sensitization was lower than 5%.…”

Section: Discussionsupporting

confidence: 75%

“…As compared with seroconversion rates recorded previously with seasonal H1N1 vaccines, such as A/New Caledonia/20/99 (H1N1), the proportion of responders among our RT patients seems to be higher. Indeed, seroconversion was only 10% in a series of 66 RT patients (versus 58% in healthy controls, P Ͻ 0.001) in a French study (8) and 36% in a Brazilian uncontrolled study of 69 patients (11). However, one should keep in mind that with seasonal vaccines, people are likely to have been vaccinated previously and therefore may show less robust subsequent vaccine response.…”

Section: Discussionmentioning

confidence: 99%

“…This work brings additional data supporting the safety of influenza vaccination in renal transplant recipients (8,33) and also documents that vaccination does not induce sensitization against HLA or MICA in dialyzed patients, who can become candidates for kidney transplantation. De novo HLA sensitization was recorded in only two patients (1.1%), a proportion even lower than the 4.8% reported by Candon et al (8). Our findings are in line with other recent publications that did not report an increase in acute rejection rates triggered by vaccination (8,9,34).…”

Section: Discussionmentioning

confidence: 99%

“…Either a single dose of 3.75 g of adjuvanted or 15 g of nonadjuvanted vaccine resulted in sero-conversion in approximately 75% to 90% of healthy volunteers (6,7). In solid organ recipients (8)(9)(10)(11) and dialysis patients (12), the overall rate of seroconversion to the seasonal flu vaccine is in the range of 30% to 50%. The use of adjuvanted vaccine has raised concerns for immunocompromised patients, because of possible induction of allo-immune responses, such as anti-human histocompatibility leukocyte antigen (HLA) antibodies (Abs) or MHC class I-related chain A (MICA) Abs (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

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Influenza A/H1N1 Vaccine in Patients Treated by Kidney Transplant or Dialysis

Broeders

Hombrouck²,

Lemy³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives In 2009, the pandemic influenza A/H1N1 accounted for worldwide recommendations about vaccination. There are few data concerning the immunogenicity or the security of the adjuvanted-A/H1N1 vaccine in transplanted and hemodialyzed patients.Design, setting, participants, & measurements Sera from 21 controls, 53 hemodialyzed (HD) patients, and 111 renal transplant recipients (RT) were sampled before (T0) and 1 month after (T1) a single dose of Pandemrix® vaccine (GSK Biologicals, AS03-adjuvanted). We measured the neutralizing antibodies against A/H1N1/2009, the geometric mean (GM) titers, the GM titer ratios (T1/T0) with 95% confidence intervals, and the seroconversion rate (responders: Ն4-fold increase in titer). The HLA and MICA immunization was determined by Luminex technology. ResultsThe GM titer ratio was 38 (19 to 78), 9 (5 to 16), and 5 (3 to 6) for controls, HD patients, and RT patients, respectively (P Ͻ 0.001). The proportion of responders was 90%, 57%, and 44%, respectively (P Ͻ 0.001). In RT patients, the prevalence of histocompatibility leukocyte antigen (HLA) class I, histocompatibility leukocyte antigen class II, and MHC class I-related chain A immunization, was, respectively, 15%, 14%, and 14% before and 14%, 14%, and 11% after vaccination (P ϭ 1, 1, and 0.39). ConclusionsThe influenza A/H1N1-adjuvanted vaccine is of limited efficacy but is safe in renal disease populations. The humoral response is lower in transplanted versus hemodialyzed patients. Further studies are needed to improve the efficacy of vaccination in those populations.

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