TY - JOUR
T1 - Immune status assessment in adult lung transplant candidates
AU - van Kessel, Diana A
AU - Hoffman, Thijs W
AU - van Velzen-Blad, Heleen
AU - van de Graaf, EA
AU - Grutters, Jan C
AU - Rijkers, Ger T
N1 - Publisher Copyright:
© 2016 Elsevier B.V.
PY - 2017/2
Y1 - 2017/2
N2 - BACKGROUND: Lung transplant recipients have an increased susceptibility to a variety of infections due to immunosuppressive therapy. Current guidelines recommend pneumococcal and other vaccinations, prior to lung transplantation to protect against post-transplant infections, but measurement of the antibody response to vaccination is not advised. Immune status investigation in lung transplant candidates, including the response to pneumococcal polysaccharide vaccination, has not been described.METHODS: Immune status investigation, including measurement of immunoglobulins, complement and the response to 23-valent pneumococcal polysaccharide vaccination (23vPPV) was performed in 81 adult lung transplant candidates.RESULTS: Eighteen patients had low IgG levels and 32 patients had low IgG1 and/or IgG2 levels. After vaccination with 23vPPV the median antibody concentration of all serotypes increased significantly. Fifty-two patients had protective IgG-post-vaccination antibody levels to at least 10 serotypes. Twenty-nine patients had an impaired response to 23vPPV.CONCLUSIONS: In conclusion, a significant proportion of our cohort of lung transplant candidates had one or more abnormalities in the immune status. It is likely that these patients have an increased risk for infections after transplantation. Revaccination, including measurement of antibody response, and possibly antibody replacement therapy should be considered to minimize infection risk.
AB - BACKGROUND: Lung transplant recipients have an increased susceptibility to a variety of infections due to immunosuppressive therapy. Current guidelines recommend pneumococcal and other vaccinations, prior to lung transplantation to protect against post-transplant infections, but measurement of the antibody response to vaccination is not advised. Immune status investigation in lung transplant candidates, including the response to pneumococcal polysaccharide vaccination, has not been described.METHODS: Immune status investigation, including measurement of immunoglobulins, complement and the response to 23-valent pneumococcal polysaccharide vaccination (23vPPV) was performed in 81 adult lung transplant candidates.RESULTS: Eighteen patients had low IgG levels and 32 patients had low IgG1 and/or IgG2 levels. After vaccination with 23vPPV the median antibody concentration of all serotypes increased significantly. Fifty-two patients had protective IgG-post-vaccination antibody levels to at least 10 serotypes. Twenty-nine patients had an impaired response to 23vPPV.CONCLUSIONS: In conclusion, a significant proportion of our cohort of lung transplant candidates had one or more abnormalities in the immune status. It is likely that these patients have an increased risk for infections after transplantation. Revaccination, including measurement of antibody response, and possibly antibody replacement therapy should be considered to minimize infection risk.
KW - Immune status investigation
KW - Lung transplant candidates
KW - Pneumococcal polysaccharide vaccination
UR - http://www.scopus.com/inward/record.url?scp=85007158480&partnerID=8YFLogxK
U2 - 10.1016/j.trim.2016.11.001
DO - 10.1016/j.trim.2016.11.001
M3 - Article
C2 - 27867073
SN - 0966-3274
VL - 40
SP - 31
EP - 34
JO - Transplant immunology
JF - Transplant immunology
ER -