*Purpose: Guidelines recommend waiting four weeks between live vaccine administration and transplantation; however, there is little data to support this waiting period and it often results in delay in transplantation, passage on an optimal organ, or foregoing the opportunity to vaccinate. The purpose of this project is to 1) define the time post-vaccination at which measles and varicella viruses become undetectable in the blood of children with liver disease and 2) determine whether children with chronic liver disease awaiting transplant mount a protective immune response to live vaccines.

*Methods: 6 children with chronic liver disease were enrolled and demographic and clinical information were collected. Viral PCRs for measles and varicella were measured weekly for four weeks post-vaccines. Antibodies (Ab) were measured pre-vaccine and again four weeks post-vaccines.

*Results: 6 children (2 with Biliary Atresia, 2 with Alagille Syndrome, 1 with PFIC, and 1 with undefined cirrhosis) received live vaccines between 6-13 months of age. All patients cleared measles and varicella by two weeks post-vaccines. A majority of children mounted a protective antibody response against measles and varicella. (Table 1)

*Conclusions: In this pilot study, no children with chronic liver disease were viremic for measles or varicella beyond two weeks post-vaccination and a majority mounted a protective antibody response. This suggests the four week waiting interval between vaccines and transplant may be unnecessary.

* VZV antibody ≥ 1.1 index value indicates immunity, 0.9-1.1 index value is equivocal

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