PMID- 28198768
OWN - NLM
STAT- MEDLINE
DCOM- 20170929
LR  - 20180215
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 101
IP  - 10
DP  - 2017 Oct
TI  - Long-term Follow-up of Humoral Immune Status in Adult Lung Transplant Recipients.
PG  - 2477-2483
LID - 10.1097/TP.0000000000001685 [doi]
AB  - BACKGROUND: Lung transplant recipients have an increased risk for infections in 
      the posttransplant period due to immunosuppressive therapy. Protection against 
      infections can be achieved through vaccination, but the optimal vaccination 
      schedule in lung transplant recipients is unknown. Data on long-term 
      immunological follow up and vaccination responses after lung transplantation are 
      scarce. METHODS: Here we present long-term immunological follow up of a cohort of 
      55 lung transplant recipients. This includes detailed antibody responses after 
      23-valent pneumococcal polysaccharide vaccination (23vPPV). RESULTS: All patients 
      were vaccinated with 23vPPV before transplantation. Median follow-up after 
      transplantation was 6.6 years (379 patient-years). After transplantation, there 
      is a significant decrease of all immunoglobulins, IgG subclasses and pneumococcal 
      polysaccharide antibodies. After the first year posttransplantation, there is a 
      gradual increase of all immunoglobulins and IgG subclasses, but values were 
      always significantly lower than in the pretransplant period. After a median of 
      4.4 years posttransplantation, patients were revaccinated with 23vPPV. The 
      pneumococcal polysaccharide antibody response was impaired in 87% of patients 
      (ie, antibody titer above cutoff and twofold increase between pre and 
      postvaccination values for <70% of serotypes). CONCLUSIONS: We found that 
      impairment of humoral immunity was most outspoken in the first year after lung 
      transplantation. Immunoglobulin levels remain decreased several years after 
      transplantation and the response to pneumococcal polysaccharide vaccine was 
      significantly lower posttransplantation compared to the pretransplantation 
      response. However, most patients did show a partial response to vaccination. 
      Based on our results, revaccination with pneumococcal vaccines after 
      transplantation should be considered 1 year after transplantation.
FAU - van Kessel, Diana A
AU  - van Kessel DA
AD  - 1 Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands. 
      2 Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The 
      Netherlands. 3 Department of Medical Microbiology and Immunology, St. Antonius 
      Hospital, Nieuwegein, The Netherlands. 4 Department of Science, University 
      College Roosevelt, Middelburg, The Netherlands.
FAU - Hoffman, Thijs W
AU  - Hoffman TW
FAU - Kwakkel-van Erp, Johanna M
AU  - Kwakkel-van Erp JM
FAU - Oudijk, Erik-Jan D
AU  - Oudijk ED
FAU - Zanen, Pieter
AU  - Zanen P
FAU - Rijkers, Ger T
AU  - Rijkers GT
FAU - Grutters, Jan C
AU  - Grutters JC
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies, Bacterial)
RN  - 0 (Pneumococcal Vaccines)
SB  - IM
MH  - Adult
MH  - Antibodies, Bacterial/immunology
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/immunology/*prevention & control
MH  - Humans
MH  - *Immunity, Humoral
MH  - Immunization Schedule
MH  - *Lung Transplantation
MH  - Male
MH  - Middle Aged
MH  - Pneumococcal Vaccines/*therapeutic use
MH  - Retrospective Studies
MH  - Streptococcus pneumoniae/*immunology
MH  - Time Factors
MH  - *Transplant Recipients
MH  - Vaccination/*methods
MH  - Young Adult
EDAT- 2017/02/16 06:00
MHDA- 2017/09/30 06:00
CRDT- 2017/02/16 06:00
PHST- 2017/02/16 06:00 [pubmed]
PHST- 2017/09/30 06:00 [medline]
PHST- 2017/02/16 06:00 [entrez]
AID - 10.1097/TP.0000000000001685 [doi]
PST - ppublish
SO  - Transplantation. 2017 Oct;101(10):2477-2483. doi: 10.1097/TP.0000000000001685.