Background:Asplenia vaccination is employed before ABO-incompatible(ABOi)transplantation in case splenectomy is needed.Pneumococcal vaccines have been reported,in different patient groups,to increase anti-A/B titers,t...Background:Asplenia vaccination is employed before ABO-incompatible(ABOi)transplantation in case splenectomy is needed.Pneumococcal vaccines have been reported,in different patient groups,to increase anti-A/B titers,through cross-reactivity to shared polysaccharide epitopes.We investigated the impact of pretransplant asplenia vaccinations on anti-A/B antibody titers in prospective ABOi renal transplant recipients.Methods:Published asplenia vaccine microbial structures were reviewed to assess expression of A/B antigens.All patients who underwent ABOi transplantation at Monash Medical Centre with anti-A/B titers taken either side of asplenia vaccination were included in a retrospective cohort study between 2007 and 2021.Patients with paired titers without intervening vaccination were included as controls.Paired titers were compared within groups.Results:A and B antigens were found to be expressed by vaccine specific pneumococcal serotypes.Thirty-nine ABOi renal transplant recipients received vaccination including at least one pneumococcal vaccine.The most common donor to recipient combination was A1 to O.The median pre-and postvaccination anti-A/B titers were 1:32 and there was no significant change in titers following vaccination(median change in titer 0 dilutions,range–2 to 3,P=0.43).The same findings were apparent in the control group(n=20).There was no significant change in titer by donor blood group or vaccine type.No transplants were canceled or delayed by a rise in anti-A/B titers postvaccination.Conclusion:Pneumococcal vaccination had no clinically relevant impact on anti-A/B titers before ABOi transplantation in this cohort.These results provide reassurance regarding the safety of asplenia vaccination before ABOi transplantation.展开更多
文摘Background:Asplenia vaccination is employed before ABO-incompatible(ABOi)transplantation in case splenectomy is needed.Pneumococcal vaccines have been reported,in different patient groups,to increase anti-A/B titers,through cross-reactivity to shared polysaccharide epitopes.We investigated the impact of pretransplant asplenia vaccinations on anti-A/B antibody titers in prospective ABOi renal transplant recipients.Methods:Published asplenia vaccine microbial structures were reviewed to assess expression of A/B antigens.All patients who underwent ABOi transplantation at Monash Medical Centre with anti-A/B titers taken either side of asplenia vaccination were included in a retrospective cohort study between 2007 and 2021.Patients with paired titers without intervening vaccination were included as controls.Paired titers were compared within groups.Results:A and B antigens were found to be expressed by vaccine specific pneumococcal serotypes.Thirty-nine ABOi renal transplant recipients received vaccination including at least one pneumococcal vaccine.The most common donor to recipient combination was A1 to O.The median pre-and postvaccination anti-A/B titers were 1:32 and there was no significant change in titers following vaccination(median change in titer 0 dilutions,range–2 to 3,P=0.43).The same findings were apparent in the control group(n=20).There was no significant change in titer by donor blood group or vaccine type.No transplants were canceled or delayed by a rise in anti-A/B titers postvaccination.Conclusion:Pneumococcal vaccination had no clinically relevant impact on anti-A/B titers before ABOi transplantation in this cohort.These results provide reassurance regarding the safety of asplenia vaccination before ABOi transplantation.
