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The Impact of the Influenza Vaccine on Pediatric Kidney Transplant Outcomes

M. Camerino,1 S. Jackson,2 S. Chinnakotla,3 P. Verghese.1

1Department of Pediatrics, University of Minnesota, Minneapolis, MN
2Fairview Health Services, Minneapolis, MN
3Department of Surgery, University of Minnesota, Minneapolis, MN.

Meeting: 2018 American Transplant Congress

Abstract number: B213

Keywords: Infection, Kidney transplantation, Pediatric, Vaccination

Session Information

Date: Sunday, June 3, 2018

Session Name: Poster Session B: Kidney: Pediatrics

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

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The influenza vaccine has been associated with de novo DSA and rejection in adult kidney recipients. This risk has not been adequately assessed in pediatric kidney recipients. In a single-center retrospective analysis of pediatric kidney recipients, we assessed graft and patient outcomes stratified by whether the patients received the influenza vaccine. From January 1, 2006 to December 31, 2015, 125 of 187 patients received the influenza vaccine within one year post-transplant. There were no significant differences in baseline characteristics between groups (values presented as N (%), Mean +/- SD or Median (IQR)).

Vaccinated n=125 Not vaccinated n=62 P value
Female 48 [38%] 30 [48%] 0.25
Recipient age 9.5 ± 0.6 10.8 ± 5.3 0.14
Donor age 31.9 ± 11.0 33.2 ± 10.7 0.44
Pre-transplant peak PRA I 3.00 [0.00; 31.0] 2.00 [0.00; 16.8] 0.08
Pre-transplant peak PRA II 2.00 [0.00; 34.0] 0.00 [0.00; 6.00] 0.32

Kaplan-Meier curves and log-rank tests were used to compare mortality, graft failure and rejection. Due to the timing of the vaccine, baseline was defined as one year post-transplant; those with events within one year of transplant had an event time of zero. The vaccinated group had a significantly decreased risk of mortality (p=0.048) after one year post-transplant. There was no difference in death-censored graft survival (p=0.253), graft survival (p=0.098), or rejection (p=0.195). Eight patients developed de novo DSA within 3 months post-vaccination; of these, 4 had persistent DSA for over 2 months. Of these 8 patients, 3 developed biopsy-proven rejection; 2 had persistent DSA, and 1 had DSA that resolved prior to rejection. In our cohort of pediatric kidney recipients, the influenza vaccine was safe; larger prospective studies are required to confirm that the vaccine is not associated with increased de novo DSA and rejection risk in pediatric kidney recipients.

CITATION INFORMATION: Camerino M., Jackson S., Chinnakotla S., Verghese P. The Impact of the Influenza Vaccine on Pediatric Kidney Transplant Outcomes Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Camerino M, Jackson S, Chinnakotla S, Verghese P. The Impact of the Influenza Vaccine on Pediatric Kidney Transplant Outcomes [abstract]. https://atcmeetingabstracts.com/abstract/the-impact-of-the-influenza-vaccine-on-pediatric-kidney-transplant-outcomes/. Accessed February 28, 2021.

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