en
Scientific article
English

Varicella-zoster immunization in pediatric liver transplant recipients: safe and immunogenic

Published inAmerican journal of transplantation, vol. 12, no. 11, p. 2974-2985
Publication date2012
Abstract

Varicella can have a severe course in immunosuppressed patients. Although prevention is fundamental, live-attenuated varicella-zoster (VZV) vaccine is not currently recommended in transplant recipients. Our aims were to (1) evaluate VZV immunity in pediatric liver transplant (LT) recipients; (2) immunize (two doses) seronegative patients post-LT; (3) monitor vaccine safety, (4) assess B and T cell vaccine responses. All patients followed at the Swiss National Pediatric LT Center were approached and 77/79 (97.5%) were enrolled (median age 7.8 years). Vaccine safety was monitored by standardized diary cards and phone calls. VZV-specific serology and CD4(+) T cells were assessed before and after immunization. Thirty-nine patients (51.1%) were seronegative including 14 children immunized pre-LT. Thirty-six of 39 seronegative patients were immunized post-LT (median 3.0 years post LT). Local (54.8%) and systemic (64.5%) reactions were mild and transient. The frequency of VZV-specific CD4(+) T cells and antibody titers increased significantly (respectively from 0.085% to 0.16%, p = 0.04 and 21.0 to 1134.5 IU/L, p < 0.001). All children reached seroprotective titers and 31/32 (97%) patients assessed remained seroprotected at follow-up (median 1.7 years). No breakthrough disease was reported during follow-up (median 4.1 years). Thereby, VZV vaccine appears to be safe, immunogenic and provide protection against disease in pediatric LT patients.

Keywords
  • Antibodies, Viral/immunology
  • Chickenpox/immunology/prevention & control
  • Chickenpox Vaccine/administration & dosage
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Graft Rejection/prevention & control
  • Graft Survival
  • Herpes Zoster/immunology/prevention & control
  • Herpes Zoster Vaccine/administration & dosage
  • Humans
  • Immunization/methods
  • Immunocompromised Host/immunology
  • Infant
  • Liver Transplantation/adverse effects/methods
  • Male
  • Retrospective Studies
  • Risk Assessment
  • Safety Management
  • Transplantation Immunology
  • Treatment Outcome
Citation (ISO format)
POSFAY BARBE, Klara et al. Varicella-zoster immunization in pediatric liver transplant recipients: safe and immunogenic. In: American journal of transplantation, 2012, vol. 12, n° 11, p. 2974–2985. doi: 10.1111/j.1600-6143.2012.04273.x
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1600-6135
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