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Am J Transplant ; 24(6): 1070-1079, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38103788

RESUMO

Pediatric liver transplant recipients are particularly at risk of infections. The most cost-effective way to prevent infectious complications is through vaccination, which can potentially prevent infections due to hepatitis B (HBV) virus, hepatitis A virus (HAV), and invasive pneumococcal diseases. Here, we performed a retrospective analysis of HBV, HAV, and pneumococcal immunity in pediatric liver transplant recipients between January 1, 2009, and December 31, 2020, to collect data on immunization and vaccine serology. A total of 94% (58/62) patients had available vaccination records. At transplant, 90% (45/50) were seroprotected against HBV, 63% (19/30) against HAV, and 78% (18/23) had pneumococcal immunity, but immunity against these 3 pathogens remained suboptimal during the 9-year follow-up. A booster vaccine was administered to only 20% to 40% of patients. Children who had received >4 doses of HBV vaccine and > 2 doses of HAV vaccine pretransplant displayed a higher overall seroprotection over time post-solid organ transplant. Our findings suggest that a serology-based approach should be accompanied by a more systematic follow-up of vaccination, with special attention paid to patients with an incomplete vaccination status at time of transplant.


Assuntos
Hepatite A , Vacinas contra Hepatite B , Vírus da Hepatite B , Hepatite B , Transplante de Fígado , Infecções Pneumocócicas , Humanos , Estudos Retrospectivos , Masculino , Feminino , Seguimentos , Criança , Hepatite B/prevenção & controle , Hepatite B/imunologia , Pré-Escolar , Hepatite A/imunologia , Hepatite A/prevenção & controle , Vacinas contra Hepatite B/imunologia , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/imunologia , Vacinas contra Hepatite A/imunologia , Vacinas contra Hepatite A/administração & dosagem , Adolescente , Lactente , Streptococcus pneumoniae/imunologia , Prognóstico , Vacinação , Transplantados , Vírus da Hepatite A/imunologia , Complicações Pós-Operatórias/imunologia
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