Live vaccines after pediatric solid organ transplant: Proceedings of a consensus meeting, 2018

Growing evidence suggests receipt of live‐attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2‐day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to...

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Published inPediatric transplantation Vol. 23; no. 7; pp. e13571 - n/a
Main Authors Suresh, Sneha, Upton, Julia, Green, Michael, Pham‐Huy, Anne, Posfay‐Barbe, Klara M., Michaels, Marian G., Top, Karina A., Avitzur, Yaron, Burton, Catherine, Chong, Pearlie P., Danziger‐Isakov, Lara, Dipchand, Anne I., Hébert, Diane, Kumar, Deepali, Morris, Shaun K., Nalli, Nadya, Ng, Vicky Lee, Nicholas, Sarah Kogan, Robinson, Joan L., Solomon, Melinda, Tapiero, Bruce, Verma, Anita, Walter, Jolan E., Allen, Upton D.
Format Journal Article
LanguageEnglish
Published Denmark Wiley Subscription Services, Inc 01.11.2019
Subjects
Graft rejection
Herd immunity
immunization
Immunological tolerance
Infectious diseases
Kidney transplantation
live vaccinations
Liver transplantation
Lymphocytes T
Measles
measles‐mumps‐rubella vaccine
Monoclonal antibodies
Mumps
Mycophenolate mofetil
Mycophenolic acid
Rituximab
Rubella
solid organ transplant
Transplants & implants
Vaccines
varicella‐zoster vaccine
measles-mumps-rubella vaccine
immunization
solid organ transplant
live vaccinations
varicella-zoster vaccine
Online AccessGet full text
ISSN1397-3142
1399-3046
1399-3046
DOI10.1111/petr.13571

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Abstract Growing evidence suggests receipt of live‐attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2‐day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post‐SOT. For consideration of VV and MMR post‐transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post‐SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell–depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in‐depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of “low‐level” immune suppression as defined in the document.
AbstractList Growing evidence suggests receipt of live‐attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2‐day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post‐SOT. For consideration of VV and MMR post‐transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post‐SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell–depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in‐depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of “low‐level” immune suppression as defined in the document.
Growing evidence suggests receipt of live‐attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2‐day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post‐SOT. For consideration of VV and MMR post‐transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post‐SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell–depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in‐depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of “low‐level” immune suppression as defined in the document.
Growing evidence suggests receipt of live-attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2-day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post-SOT. For consideration of VV and MMR post-transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post-SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell-depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in-depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of "low-level" immune suppression as defined in the document.Growing evidence suggests receipt of live-attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in herd immunity. A 2-day consortium of experts in infectious diseases, transplantation, vaccinology, and immunology was held with the objective to review evidence and create expert recommendations for clinicians when considering live viral vaccines post-SOT. For consideration of VV and MMR post-transplant, evidence exists only for kidney and liver transplant recipients. For MMR vaccine post-SOT, consider vaccination during outbreak or travel to endemic risk areas. Patients who have received antiproliferative agents (eg. mycophenolate mofetil), T cell-depleting agents, or rituximab; or have persistently elevated EBV viral loads, or are in a state of functional tolerance, should be vaccinated with caution and have a more in-depth evaluation to define benefit of vaccination and net state of immune suppression prior to considering vaccination. MMR and/or VV (not combined MMRV) is considered to be safe in patients who are clinically well, are greater than 1 year after liver or kidney transplant and 2 months after acute rejection episode, can be closely monitored, and meet specific criteria of "low-level" immune suppression as defined in the document.
Author Suresh, Sneha
Dipchand, Anne I.
Kumar, Deepali
Green, Michael
Allen, Upton D.
Morris, Shaun K.
Nicholas, Sarah Kogan
Walter, Jolan E.
Nalli, Nadya
Ng, Vicky Lee
Robinson, Joan L.
Michaels, Marian G.
Burton, Catherine
Top, Karina A.
Hébert, Diane
Upton, Julia
Verma, Anita
Chong, Pearlie P.
Posfay‐Barbe, Klara M.
Solomon, Melinda
Tapiero, Bruce
Pham‐Huy, Anne
Avitzur, Yaron
Danziger‐Isakov, Lara
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  organization: University of Cincinnati
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  organization: University Health Network
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  organization: Hospital for Sick Children
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/31497926$$D View this record in MEDLINE/PubMed
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Keywords measles-mumps-rubella vaccine
immunization
solid organ transplant
live vaccinations
varicella-zoster vaccine
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crossref_citationtrail_10_1111_petr_13571
crossref_primary_10_1111_petr_13571
wiley_primary_10_1111_petr_13571_PETR13571
PublicationCentury 2000
PublicationDate November 2019
PublicationDateYYYYMMDD 2019-11-01
PublicationDate_xml – month: 11
  year: 2019
  text: November 2019
PublicationDecade 2010
PublicationPlace Denmark
PublicationPlace_xml – name: Denmark
– name: Hoboken
PublicationTitle Pediatric transplantation
PublicationTitleAlternate Pediatr Transplant
PublicationYear 2019
Publisher Wiley Subscription Services, Inc
Publisher_xml – name: Wiley Subscription Services, Inc
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Snippet Growing evidence suggests receipt of live‐attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in...
Growing evidence suggests receipt of live-attenuated viral vaccines after solid organ transplant (SOT) has occurred and is safe and needed due to lapses in...
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SubjectTerms Graft rejection
Herd immunity
immunization
Immunological tolerance
Infectious diseases
Kidney transplantation
live vaccinations
Liver transplantation
Lymphocytes T
Measles
measles‐mumps‐rubella vaccine
Monoclonal antibodies
Mumps
Mycophenolate mofetil
Mycophenolic acid
Rituximab
Rubella
solid organ transplant
Transplants & implants
Vaccines
varicella‐zoster vaccine
Title Live vaccines after pediatric solid organ transplant: Proceedings of a consensus meeting, 2018
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fpetr.13571
https://www.ncbi.nlm.nih.gov/pubmed/31497926
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Volume 23
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