Background: Infections in solid organ transplant recipients, some of which are vaccine preventable, may result in excessive morbidity and mortality. Immunosuppressive agents increase the risk of such serious infections and also impair the immunological response to vaccines. Vaccination is most effective if it is given prior to transplantation; and prior to the initiation of chronic immunosuppression. Immunizations should be administered as early as possible during the transplant evaluation period in order to optimize the immune response. In this study, we examined the immunization status of listed kidney transplant candidates in our renal transplant program to identify the gaps between the current recommendations and the immunization status for this high-risk population. We focused on the patients who are currently not receiving hemodialysis as there is a vast amount of information in patients on hemodialysis.

Methods: We performed a retrospective chart review of patients who were listed as potential kidney transplant candidates and who are not currently on hemodialysis at Ochsner Health System (500 + bed tertiary care center) to evaluate the compliance rate of vaccinations for pneumococcus, influenza and hepatitis B virus. Hepatitis B surface antibodies (HBsAb) were also recorded to determine if patients had immunity against hepatitis B.

Results: One hundred and forty patients met criteria. The mean age was 57 years old; The immunization rates for all 3 vaccines were low. Only 36.88% of patients received pneumococcal vaccine; 47.52% received influenza vaccine; and 25.90% received 3 doses of hepatitis B vaccine. Immunity against hepatitis B virus as documented by a HBsAb titer was found only in 9.93% of listed patients.

Conclusion: The overall immunization compliance rate was found to be low for pneumococcus, influenza and hepatitis B vaccines. This suggests that there is a significant gap between the immunization status and the current vaccine recommendations for such high risk population. An integrated routine workflow needs to be in place during our pre-transplant evaluation process so we can effectively engage our specialists and staff in vaccine adherence improvement.

CITATION INFORMATION: Tawhari I, Staffeld-Coit C, Garcia-Diaz J. Vaccination Compliance in Listed Kidney Transplant Candidates: A Retrospective Chart Review. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress