*Purpose: SOT recipients are at risk of acquiring life-threatening infections putting their graft and life at risk. Prevention, including immunization with live virus vaccines pre-transplantation plays a pivotal role for survival of patients and their grafts. The main aim of this study was to investigate the number of HLL transplant recipients who were evaluated for their immune status against MMR /VZV. A secondary objective was to determine if a pre-transplant IDC improved vaccination rates among those lacking immunity against MMR/VZV.

*Methods: This QA study was an institution-based retrospective analysis. All HLL SOT candidates born in/after 1957 evaluated at Mayo Clinic, FL between January 2016 and December 2017 were included. Institutional IRB approval was obtained. The number of patients evaluated by Infectious Disease (ID), screened serologically for MMR/VZV, and vaccinated if seronegative pre-transplantation were retrospectively collected from medical records. The vaccination rates of SOT candidates were compared by univariate analysis based on IDC and no ID consultation (NIDC).

*Results: A total 242 of HLL transplant patients were included. 187 (77%) of 242 patients received an IDC pre transplantation. Varicella IgG levels were screened in all 187 IDC candidates. But 7 (12.7%) of 55 were among NIDC. Among the 187 IDC patients, mumps IgG, measles IgG, and rubella IgG were done in 9 (5%), 21 (11%) and 51 (27%), respectively. Among all 242 patients, vaccines were given 2 (0.8%) for MMR, 10 (4.1%) for Varicella and 85 (35.12%) for Zostavax. Univariate analysis revealed that Zostavax was given to 76 (40.6%) of pre-transplant IDC patients and only in 9 (16.7%) of NIDC (p<.001).

*Conclusions: This study shows that the majority of patients had IDC prior to transplantation. Despite the relatively high IDC rate, patients’ screened numbers for MMR IgG levels were low. No institutional protocol for screening of MMR IgG existed; however did for VZV. Results pointed out the need of MMR protocol driven serologic screening and IDC prior to transplantation. The low rate of MMR screening in the absence of IDC or a protocol was found. Pre-transplant IDC was critical in achieving varicella vaccination compared to NIDC. MMR protocol driven serologic screening among these patients is recommended.

« Back to 2019 American Transplant Congress