This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Duchini, A. Articles by Pockros, P. J. Search for Related Content PubMed PubMed Citation Articles by Duchini, A. Articles by Pockros, P. J.

Next Article 

Clinical Microbiology Reviews, July 2003, p. 357-364, Vol. 16, No. 3
0893-8512/03/$08.00+0     DOI: 10.1128/CMR.16.3.357-364.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols

Andrea Duchini,^1* John A. Goss,² Saul Karpen,³ and Paul J. Pockros⁴

Divisions of Gastroenterology,¹ Surgery and Organ Transplantation,² Pediatrics,³ Baylor College of Medicine, Houston, Texas 77030, and Division of Gastroenterology, Scripps Clinic, La Jolla, California⁴

Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population.

---

* Corresponding author. Mailing address: Division of Gastroenterology, Baylor College of Medicine, 6550 Fannin, Suite 1122, Houston, TX 77030. Phone: (713) 790-2171. Fax: (713) 790-6216. E-mail: aduchini{at}bcm.tmc.edu.

---

Clinical Microbiology Reviews, July 2003, p. 357-364, Vol. 16, No. 3
0893-8512/03/$08.00+0     DOI: 10.1128/CMR.16.3.357-364.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Lima, E. Q., Silva, R. G., Fernandes, I. M. M., Abbud-Filho, M., Burdmann, E. A. (2007). Tetanus-Induced Acute Kidney Injury in a Renal Transplant Recipient. Am J Trop Med Hyg 77: 400-402 [Abstract] [Full Text]  
• Valujskikh, A., Li, X. C. (2007). Frontiers in Nephrology: T Cell Memory as a Barrier to Transplant Tolerance. J. Am. Soc. Nephrol. 18: 2252-2261 [Full Text]  
• Wertheim, M S, Keel, M, Cook, S D, Tole, D M (2006). Corneal transplant rejection following influenza vaccination. Br J Ophthalmol 90: 925-925 [Full Text]  
• Kotton, C. N., Fishman, J. A. (2005). Viral Infection in the Renal Transplant Recipient. J. Am. Soc. Nephrol. 16: 1758-1774 [Abstract] [Full Text]