Published online Jan 16, 2019. doi: 10.5500/wjt.v9.i1.1
Peer-review started: September 29, 2018
First decision: October 16, 2018
Revised: November 13, 2018
Accepted: January 1, 2019
Article in press: January 1, 2019
Published online: January 16, 2019
Vaccine preventable diseases account for a significant proportion of morbidity and mortality in transplant recipients and cause adverse outcomes to the patient and allograft. Patients should be screened for vaccination history at the time of pre-transplant evaluation and vaccinated at least four weeks prior to transplantation. For non-immune patients, dead-vaccines can be administered starting at six months post-transplant. Live attenuated vaccines are contraindicated after transplant due to concern for infectious complications from the vaccine and every effort should be made to vaccinate prior to transplant. Since transplant recipients are on life-long immunosuppression, these patients may have lower rates of serological conversion, lower mean antibody titers and waning of protective immunity over shorter period as compared to general population. Recommendations regarding booster dose in kidney transplant recipients with sub-optimal serological response are lacking. Travel plans should be part of routine post-transplant assessment and pre-travel vaccines and counseling should be provided. More studies are needed on vaccination schedules, serological response, need for booster doses and safety of live attenuated vaccines in this special population.
Core tip: Vaccine-preventable disease can cause adverse patient and allograft outcomes in kidney transplant recipients. Patients should be screened for vaccinations pre-transplant and catch up immunization should be provided at least four weeks prior to transplantation. For non-immune patients, catch-up immunization should start six months post-transplantation. Live attenuated vaccines are contra-indicated in transplant patients. There is limited data that suggests safety of live vaccines in selective population on low immunosuppression. Travel plans should be part of routine post-transplant assessment and pre-travel vaccines and counseling should be provided.