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Impact of Seasonal Influenza Immunization (Influenza+ H1N1) on HLA Antibodies and Kidney Allograft Function

M. Mujtaba, M. Urabi, A. Sanjiv, A. Sharfuddin, N. Higgins, S. Faiz, M. Yaqub, D. Mishler, A. Lobashevsky, T. Taber

Indiana University School of Medicine, Indianapolis, IN

Meeting: 2013 American Transplant Congress

Abstract number: 420

Seasonal influenza vaccine (influenza + H1N1) is recommended for all solid organ transplant patients. Vaccines have been implicated in changes to HLA antibody profile with the possibility of increased risk for rejection post transplant.

At our center, all kidney transplant recipients are monitored pre transplant for HLA antibodies and many are monitored post transplant for development of donor specific antibody. This provided us the opportunity to compare pre and post vaccine HLA antibodies along with kidney allograft function, including rate of rejection.

Fifty seven kidney transplant recipients were identified as having received influenza vaccine where pre (median 90 days)and post (50 days) vaccine HLA testing was available. HLA antibody testing was performed using solid phase single antigen beads with results expressed as Mean Fluorescence intensity (MFI).

Out of these patient, 7 had pre immunization donor specific (DSA) HLA as well as non-DSA HLA, 17 patient had non-DSA HLA antibodies and 33 patient had no HLA antibodies.Median age was 53 years, 67% patients recieved deceased donor kidney, immunization was at a median of 18 months post transplant. Post immunization, none of these patients developed rejection through the most recent follow up. Pre and post immunization 1 and 6 month serum creatinine was 1.29+0.34 mg/dl, 1.32±0.37 and 1.29±0.35 respectively (p=ns). In patients with DSA, using cumulative MFI’s, Class(C)I and CII DSA pre and post immunization was 2400 MFI vs. 2600 MFI (p=0.22); CI alone: 2050 MFI vs. 9100 MFI (p=0.12); CII alone: 3200 MFI vs. 1900 MFI (p=0.97). In patients with non-DSA HLA cumulative CI & CII pre and post immunization was 15600 MFI vs. 23800 MFI (p=0.28); CI: 13700 MFI vs. 16500 MFI (p=0.78); CII 34700 MFI vs. 39400 MFI (p=0.21) respectively. None of the patients developed any new DSA’s or new non DSA HLA antibodies. The HLA antibody status of 33 patients without any HLA antibodies pre immunization did not change afterwards.

Conclusion: Seasonal influenza vaccination is not associated with the development of new HLA antibodies or any significant changes in pre-existing HLA profile. Immunization against influenza and H1N1 does not increase the risk of rejection.

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To cite this abstract in AMA style:

Mujtaba M, Urabi M, Sanjiv A, Sharfuddin A, Higgins N, Faiz S, Yaqub M, Mishler D, Lobashevsky A, Taber T. Impact of Seasonal Influenza Immunization (Influenza+ H1N1) on HLA Antibodies and Kidney Allograft Function [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/impact-of-seasonal-influenza-immunization-influenza-h1n1-on-hla-antibodies-and-kidney-allograft-function/. Accessed June 6, 2025.

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