Pre‐transplant vaccination compliance in adult heart and lung transplant recipients

Abstract

Background: Vaccine preventable diseases can affect solid organ transplant recipients post-transplant. Therefore, the administration of vaccines and assessment of serologic response should be prioritized in the pre-transplant period.Methods: This single-center, retrospective study included 349 adult heart or lung transplant candidates between December 1, 2017 and November 30, 2019. We describe vaccination or serologic status for hepatitis A, hepatitis B, tetanus, pneumococcal, influenza, and other recommended vaccinations among heart or lung transplant candidates.Results: Eighty-two heart transplant candidates (91%) and 77 lung transplant candidates (30%) received an ID consult prior to transplant. More patients completed the pneumococcal series (66.7% vs. 28.6%, P = .045) in the heart transplant group that received an ID consult. In the lung transplant group, patients with an ID consult demonstrated higher rates of immunity to hepatitis A (84.4% vs. 72.9%, P = .047), hepatitis B (75.3% vs. 56.9%, P = .005), and measles (71.4% vs. 52.5%, P = .005) compared to those without. Conclusions:Our results demonstrate the value of consulting ID and administering vaccinations in the early evaluation phase, prior to transplant listing. Opportunities remain to better optimize vaccination rates prior to transplant in heart and lung transplant candidates.

Approaches to pretransplant vaccination

“…Several interventions have been used to close the care coordination gap. Multiple studies have shown that transplant infectious diseases consultation in the pretransplant period is associated with higher rates of vaccination and seroresponse, compared with candidates who do not meet with an infectious diseases specialist [30 ▪ ,31 ▪ ]. These consultations may be most effective when linked to universal screening and vaccination protocols.…”