Background: Annual influenza vaccination is usually recommended in solid-organ transplant (SOT) recipients. However, concerns have been raised about the impact of vaccination on alloimmunity. We evaluated the humoral alloimmune responses before and after influenza vaccination in a cohort of SOT recipients during several influenza seasons.
Methods: We reviewed 169 stable SOT recipients, who received the influenza vaccine between October 2008 and December 2011. Anti-HLA antibodies were measured before and 4-8 weeks after vaccination using Solid Phase Assay (Luminex LABScreen Mixed, Luminex LABScreen Single Antigen Class I/II). The positive cut-off level was defined at 2000 MFI. Rejection episodes within 12 months after vaccination were registered, and serum creatinine levels were followed in kidney transplant recipients.
Results: Overall, 169 SOT recipients were included (kidney=136, lung=26, liver=3 and combined transplant=4). Positive anti-HLA results were observed in 35 (21%) of 169 patients before vaccination, and in 34 (20%) of 169 patients after vaccination. In patients with pre-existing antibodies, titers were not significantly different before and after vaccination (9060 MFI vs. 9348 MFI, respectively, p=0.47) and no development of de novo donor specific antibody (DSA) was observed. Four (2.4%) of 169 patients developed de novo anti-HLA antibodies, but none of these were DSA. Five episodes of rejection (3.0%) were observed within 12 months after vaccination. None of these episodes were seen in patients with de novo anti-HLA antibodies after vaccination. In kidney transplant recipients, no significant change in serum creatinine levels was observed after vaccination (p=0.88). 44 patients (26%) were followed for more than one influenza season; no significant change in MFI of anti-HLA antibodies was observed.
Conclusions: The incidence of development of anti-HLA antibodies after influenza vaccination in our cohort of SOT recipients was very low. Our findings indicate that influenza vaccination is safe and does not trigger alloimmune responses in SOT recipients.
To cite this abstract in AMA style:Vermeiren P, Aubert V, Sugamele R, Aubert J, Venetz J, Meylan P, Pascual M, Manuel O. Influenza Vaccination and Humoral Alloimmunity in Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/influenza-vaccination-and-humoral-alloimmunity-in-solid-organ-transplant-recipients/. Accessed January 17, 2021.
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