Tags

Type your tag names separated by a space and hit enter

Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation.
Transplantation. 1998 Nov 27; 66(10):1340-7.T

Abstract

INTRODUCTION

Patients after solid organ transplantation are at an increased risk for microbial infections. Due to therapeutic immunosuppression, the response to active immunizations may be reduced. The serological efficacy of pneumococcal and influenza vaccination was studied in heart transplant recipients.

PATIENTS AND METHODS

Sixteen patients over 1 year after heart transplantation and control patients were immunized with a 23-valent pneumococcal vaccine and a triple-split influenza vaccine. Pre- and postvaccinal antibody titers were serologically determined, including quantitation of specific antibodies against nine pneumococcal serotypes.

RESULTS

Both vaccines were well tolerated without systemic reactions or infectious complications. Median postvaccinal pneumococcal antibody titers in the transplant patients were comparable to controls (5513 U/ml, range: 694-41007, vs. 5490 U/ml, range: 1088-38042; P=NS); vaccination was successful in 23/23 (100%) of controls and in 15/16 (94% plus 1 borderline positive case) of the transplant recipients. Specific antibody titers were similar for eight of nine serotypes; only the immune response against serotype 3 was reduced after transplantation. The efficacy of influenza vaccination was significantly impaired in transplant patients against all three virus strains (62% vs. 97%, P<0.01/50% vs. 94%, P<0.001/37% vs. 80%, P<0.01), but 9/16 (56%) of patients still showed a sufficient immune response to two out of three virus strains. No clinical or demographic predictors of successful vaccination could be established.

CONCLUSIONS

Pneumococcal vaccination under cyclosporine-based immunosuppression after heart transplantation is safe and equally effective as in healthy controls. In contrast, the immune response to influenza vaccination is significantly reduced, although not completely abolished. This differential response might be accounted for by T cell-independent antibody production against polysaccharide antigens contained in the pneumococcal vaccine.

Authors+Show Affiliations

Department of Cardiology, Medical University Hospital, University of Heidelberg, Germany. thomas.dengler@yale.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9846520

Citation

Dengler, T J., et al. "Differential Immune Response to Influenza and Pneumococcal Vaccination in Immunosuppressed Patients After Heart Transplantation." Transplantation, vol. 66, no. 10, 1998, pp. 1340-7.
Dengler TJ, Strnad N, Bühring I, et al. Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation. Transplantation. 1998;66(10):1340-7.
Dengler, T. J., Strnad, N., Bühring, I., Zimmermann, R., Girgsdies, O., Kubler, W. E., & Zielen, S. (1998). Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation. Transplantation, 66(10), 1340-7.
Dengler TJ, et al. Differential Immune Response to Influenza and Pneumococcal Vaccination in Immunosuppressed Patients After Heart Transplantation. Transplantation. 1998 Nov 27;66(10):1340-7. PubMed PMID: 9846520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation. AU - Dengler,T J, AU - Strnad,N, AU - Bühring,I, AU - Zimmermann,R, AU - Girgsdies,O, AU - Kubler,W E, AU - Zielen,S, PY - 1998/12/10/pubmed PY - 1998/12/10/medline PY - 1998/12/10/entrez SP - 1340 EP - 7 JF - Transplantation JO - Transplantation VL - 66 IS - 10 N2 - INTRODUCTION: Patients after solid organ transplantation are at an increased risk for microbial infections. Due to therapeutic immunosuppression, the response to active immunizations may be reduced. The serological efficacy of pneumococcal and influenza vaccination was studied in heart transplant recipients. PATIENTS AND METHODS: Sixteen patients over 1 year after heart transplantation and control patients were immunized with a 23-valent pneumococcal vaccine and a triple-split influenza vaccine. Pre- and postvaccinal antibody titers were serologically determined, including quantitation of specific antibodies against nine pneumococcal serotypes. RESULTS: Both vaccines were well tolerated without systemic reactions or infectious complications. Median postvaccinal pneumococcal antibody titers in the transplant patients were comparable to controls (5513 U/ml, range: 694-41007, vs. 5490 U/ml, range: 1088-38042; P=NS); vaccination was successful in 23/23 (100%) of controls and in 15/16 (94% plus 1 borderline positive case) of the transplant recipients. Specific antibody titers were similar for eight of nine serotypes; only the immune response against serotype 3 was reduced after transplantation. The efficacy of influenza vaccination was significantly impaired in transplant patients against all three virus strains (62% vs. 97%, P<0.01/50% vs. 94%, P<0.001/37% vs. 80%, P<0.01), but 9/16 (56%) of patients still showed a sufficient immune response to two out of three virus strains. No clinical or demographic predictors of successful vaccination could be established. CONCLUSIONS: Pneumococcal vaccination under cyclosporine-based immunosuppression after heart transplantation is safe and equally effective as in healthy controls. In contrast, the immune response to influenza vaccination is significantly reduced, although not completely abolished. This differential response might be accounted for by T cell-independent antibody production against polysaccharide antigens contained in the pneumococcal vaccine. SN - 0041-1337 UR - https://www.unboundmedicine.com/medline/citation/9846520/Differential_immune_response_to_influenza_and_pneumococcal_vaccination_in_immunosuppressed_patients_after_heart_transplantation_ L2 - https://doi.org/10.1097/00007890-199811270-00014 DB - PRIME DP - Unbound Medicine ER -