Faculty Collaboration Database

Influenza vaccine antibody responses in lung transplant recipients. Prog Transplant 2004 Dec;14(4):346-51

Date

01/25/2005

Pubmed ID

15663020

DOI

10.1177/152692480401400410

Scopus ID

2-s2.0-13844306522 (requires institutional sign-in at Scopus site)   68 Citations

Abstract

CONTEXT: Lung transplant recipients are at high risk of morbidity and mortality from influenza infection because of altered lung physiology and immunosuppression. Annual influenza immunization is recommended, but the ability to mount an antibody response may be limited by immunosuppressant medications.

OBJECTIVE: To compare the antibody response rate to influenza vaccine in lung transplant recipients to healthy controls.

DESIGN: Open label study.

SETTING: Lung transplant clinic and General Clinical Research Center at a university hospital.

SUBJECTS: Sixty-eight single and bilateral lung transplant recipients and 35 healthy controls were enrolled in October and November 2002.

METHODS: Each individual underwent blood sampling before receiving the 2002-2003 influenza vaccine and 4 weeks later. Influenza antibody concentrations were measured by hemagglutination inhibition assay. Vaccine response rates (antibody concentration >40 hemagglutination units and at least 4-fold increase in antibody concentration) were compared using chi2. The influence of specific immunosuppressants on vaccine response was compared.

RESULTS: The influenza vaccine response rate for lung transplant recipients was 29/68 (43%) and 22/35 (63%) for the healthy individuals (P < .05; chi2). Among the recipients, mycophenolate mofetil was associated with poorer influenza vaccine antibody response (> 40 hemagglutination units) (62% vs 91%; P = .01), whereas sirolimus (91% vs 63%; P = .02) was associated with better influenza antibody response compared to those not taking mycophenolate mofetil or sirolimus, respectively.

CONCLUSION: Lung transplant recipients had lower influenza vaccine response rates than healthy individuals. Influenza vaccine antibody response is influenced by concomitant administration of mycophenolate mofetil or sirolimus. Future studies should measure protection from influenza infection conferred by immunization and alternative vaccination strategies.

Author List

Hayney MS, Welter DL, Francois M, Reynolds AM, Love RB

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antibody Formation
Case-Control Studies
Chi-Square Distribution
Female
Humans
Immunosuppressive Agents
Influenza Vaccines
Influenza, Human
Lung Transplantation
Male
Middle Aged
Statistics, Nonparametric