Prevention of infection and optimizing vaccination in the solid organ transplant candidate and recipient

Abstract

Purpose of review Infections can result in serious complications in solid organ transplant (SOT) patients. The need to remain up to date on recommendations on screening, vaccinations, and chemoprophylaxis is paramount in the management of SOT patients. The goal of this review is to provide an overview of current recommendations for the prevention of infections and optimization of vaccinations from the pretransplant through posttransplant periods. Recent findings There is an emphasis on thorough pretransplant evaluation to guide clinicians and pretransplant testing based on epidemiological and endemic risk factors. Additionally, recent studies on vaccine safety and efficacy of newer vaccine formulations in SOT recipients are addressed. Summary This review provides insight on updated recommendations for pretransplant screening, new data on vaccine optimization in SOT recipients and posttransplant prophylaxis. Further research is needed in order to improve preventive measures including screening tests, vaccines, and chemoprophylaxis.

Early humoral immune response to two doses of severe acute respiratory syndrome coronavirus 2 vaccine in a diverse group of solid organ transplant candidates and recipients

“…Pretransplant vaccinations against influenza, Hepatitis A and B, Pertusis, Diptheria, Tetanus, poliovirus, and a host of other viruses are already recommended and commonly administered. 36 However, some pre-transplant patients remain hesitant to receive the COVID-19 vaccine. [37][38][39][40] In two surveys from Germany, < 10% of liver transplant candidates 37 and 26% of heart transplant candidates 38 expressed desire to avoid vaccine while 30% of kidney and liver transplant recipients surveyed in Pennsylvania indicated they would not consider vaccination.…”

“…The increased risk of mortality and significant morbidity experienced by transplant candidates and recipients related to COVID‐19 disease, together with the poor response of transplant recipients to the COVID‐19 vaccine, portends the importance of pre‐transplant vaccination. Pretransplant vaccinations against influenza, Hepatitis A and B, Pertusis, Diptheria, Tetanus, poliovirus, and a host of other viruses are already recommended and commonly administered 36 . However, some pre‐transplant patients remain hesitant to receive the COVID‐19 vaccine 37–40 .…”