Immunity Rates to Hepatitis B Among Solid Organ Transplant Recipients
1Infectious Disease, University of Alabama at Birmingham Hospital, Birmingham, AL, 2University of Alabama at Birmingham, Birmingham, AL, 3University of Alabama at Birmingham Hospital, Birmingham, AL, 4University of Alabama, Birmingham, AL
Meeting: 2022 American Transplant Congress
Abstract number: 589
Keywords: HB vaccine, Hepatitis B, Vaccination
Topic: Administrative » Administrative » 01 - Quality Assurance Process Improvement & Regulatory Issues
Session Information
Session Name: Quality Assurance Process Improvement & Regulatory Issues
Session Type: Rapid Fire Oral Abstract
Date: Tuesday, June 7, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-5:40pm
Location: Hynes Room 206
*Purpose: Immunosuppression after transplantation decreases vaccine responsiveness. Thus, to be best protected from post-transplant communicable diseases, vaccination of organ transplant candidates in the pre-transplant period is optimal.1-3. With the increased utilization of organs from donors who meet increased risk criteria in the US4,5, particularly hepatitis B & C infected or exposed donors6,7, the OPTN is anticipated to recommend transplant centers offer and document uptake of HBV vaccination prior to transplantation5. As a result of this anticipated OPTN guidance, we examined pre-transplant immunity to HBV among transplant recipients in the Deep South.
*Methods: We conducted a retrospective study among individuals who underwent lung, liver, and heart transplant from 2018-2020 at a single US academic medical center. We reviewed medical records for HBV serologies during the index hospitalization for transplantation. Immunity to HBV was determined based on a positive anti-HBs result documented in the medical record.
*Results: A total of 452 patient records were reviewed. Overall, 29.4% of the population demonstrated immunity to HBV. The highest immunity rate was among heart/lung (66.7%) and lung transplant (32.5%) recipients. Females had a higher immunity rate than males (36.3% vs. 25.8%) and there was a higher rate of immunity among ages 18-34 and 35-49 (40% and 39.4%). Caucasians had the lowest immunity rate at 26.3% but accounted for 70% of all transplant recipients. Further demographic data are detailed in Table 1.
*Conclusions: Our study found that immunity to HBV was lacking among 70% of heart, lung, and liver transplant recipients at our center. No universal system existed in the medical records to determine if prior vaccination was administered. Given the suboptimal seroprotection among our patients, we concluded that a standardized approach to vaccination during the transplant evaluation process is vital for the post-transplant course. As a result of our findings, we established a NP-led pre-transplant clinic to focus on vaccination review, increasing vaccine uptake, and infection prevention education post-transplant.
| Organ | HBV Immunity | Race | HBV Immunity | Gender | HBV Immunity | Age | HBV Immunity |
| Heart (n=67) | 15(22.4%) | Asian (n=7) | 3(42.9%) | Male (n=295) | 76(25.8%) | < 18 y/o (n=3) | 2(66.7%) |
| Lung (n=40) | 13(32.5%) | Black (n=77) | 31(40.3%) | Female (n=157) | 57(36.3%) | 18-34 y/o (n=40) | 16(40%) |
| Heart/Lung (n=9) | 6(66.7%) | Hispanic/Latino (n=5) | 2(40%) | 35-49 y/o (n=94) | 37(39.4%) | ||
| Liver (n=336) | 99(29.5%) | White (n=361) | 95(26.3%) | 50-64 y/o (n=229) | 58(25.3%) | ||
| All Organs (n=452) | 133(29.4%) | Other(n=2) | 2(100%) | ≥ 65 y/o (n=86) | 20(23.3%) |
To cite this abstract in AMA style:
Kopf S, Walker J, Bruxvoort K, Budhwani H, Nellore A. Immunity Rates to Hepatitis B Among Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/immunity-rates-to-hepatitis-b-among-solid-organ-transplant-recipients/. Accessed December 3, 2024.« Back to 2022 American Transplant Congress