Höcker B, et al. - Herein, researchers analyzed vaccination titres pre- and post-renal transplant in patients with serial titre measurements in comparison with published data in healthy children. Pre-transplant positive vaccination titres were observed in a low percentage of patients. Researchers also observed a low revaccination rate post-transplant with limited antibody response and a high rate of vaccination titre losses.

Methods

• In the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), researchers carried out a multi-centre, multi-national study and assessed vaccination titres pre- and post-transplant in 155 patients with serial titre measurements in comparison with published data in healthy children.

Results

• Findings demonstrated that the percentage of patients with positive vaccination titres before renal transplantation (RTx) was low, particularly for diphtheria (38.5%, control 75%) and pertussis (21.3%, control 96.3%).
• Prior to RTx, a hepatitis B antibody (HBsAb) titre >100 IU/L was detected in as few as 58.1% of patients.
• A vaccination titre loss post-transplant was demonstrated by 38.1% of patients.
• A significantly (p < 0.05) more frequent hepatitis B vaccination titre loss post-transplant was experienced by patients with an HBsAb titre between 10 and 100 IU/L before RTx, compared with patients with an HBsAb titre >100 IU/L.
• Researchers observed a low revaccination rate post-transplant and they noted that revaccination failed to induce positive titres in a considerable number of patients (27.3 to 83.3%).
• In addition, in association with rituximab treatment, a significantly increased risk of a vaccination titre loss post-transplant was observed (odds ratio 4.26, p=0.033).