Live vaccines after pediatric solid organ transplant: Proceedings of a consensus meeting, 2018

Sneha Suresh, Julia Upton, Michael Green, Anne Pham-Huy, Klara M. Posfay-Barbe, Marian G. Michaels, Karina A. Top, Yaron Avitzur, Catherine Burton, Pearlie P. Chong, Lara Danziger-Isakov, Anne I. Dipchand, Diane Hébert, Deepali Kumar, Shaun K. Morris, Nadya Nalli, Vicky Lee Ng, Sarah Kogan Nicholas, Joan L. Robinson, Melinda SolomonBruce Tapiero, Anita Verma, Jolan E. Walter, Upton D. Allen

Résultat de recherche: Articleexamen par les pairs

75 Citations (Scopus)

Résumé

Growing evidence suggests receipt of live-attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2-day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post-SOT. For consideration of VV and MMR post-transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post-SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell–depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in-depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of “low-level” immune suppression as defined in the document.

Langue d'origineEnglish
Numéro d'articlee13571
JournalPediatric Transplantation
Volume23
Numéro de publication7
DOI
Statut de publicationPublished - nov. 1 2019

Note bibliographique

Funding Information:
We would like to acknowledge all conference attendees and author contributions to this endeavor. While the document will provide guidance to clinicians, the recommendations do not by themselves represent exclusive courses of action. We would like to thank the Transplant and Regenerative Medicine Centre (TRMC) at the Hospital for Sick Children for financial and administrative support for this initiative. Special thanks to Kathryn Breckbill, Christine Garner, and Susan Stinson‐Lypka for their assistance in making this initiative possible. All authors reviewed the document prior to publication.

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

ASJC Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

PubMed: MeSH publication types

  • Consensus Development Conference
  • Journal Article

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