ESPN 53rd Annual Meeting

ESPN 2021


 
How Long Does Protection by Hepatitis-B Vaccine Last After Renal Transplantation?
Gökçen Erfidan 1 Seçil Arslansoyu Çamlar 2 Özgür Özdemir Şimşek 1 Demet Alaygut 1 Fatma Mutlubaş 2 Dilek Yılmaz Çiftdoğan 3 Belde Kasap Demir 4

1- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatrics, Division of Nephrology, Izmir, Turkey
2- University of Health Sciences, Izmir Faculty of Medicine, Department of Pediatrics, Division of Nephrology, Izmir, Turkey
3- İzmir Katip Celebi University, Faculty of Medicine, Department of Pediatrics, Division of Infectious Diseases, Izmir, Turkey
4- İzmir Katip Celebi University, Faculty of Medicine, Department of Pediatrics, Division of Nephrology and Rheumatology, Izmir, Turkey
 
Introduction:

Kidney transplant candidates and recipients have a high risk for infectious diseases which are preventable with vaccination. Monitoring the serology in pre- and post-transplant periods may guide during follow-up, as these patients vaccine responses have decreased due to existing renal failure and immunosuppressive treatments. The aim was to determine the course of Hepatitis-B titers in pediatric renal transplant recipients. 

Material and methods:

A retrospective analysis of the patients was performed in a single center. The Hepatitis-B surface antibody (Anti-HBs) titer >10 mIU/mL was considered positive. The most recent pre-transplant titer and the lowest post-transplant titer during follow-up were compared.

Results:

A total of 30 patients were involved. Transplantation age was 9.5±4.4 years, and current age was 15.5±5.8 years. Male/female ratio was 2. Cadaveric transplantation was performed in 40% of them. There was a significant decrease in Anti-HBs titers after transplantation. No relationship was found between the Anti-HBs titers and primary disease/donor type. The ratio of positive serology was similar in pre- and post-transplant periods (86.7% and 70%, respectively). Pre-transplant positive patients(n=26) were divided into two groups as “titer >100 mIU/mL” and “titer between 10 and 100 mIU/mL”. The second group had significantly lower titers after transplantation, while the first group had similar titers. Six(23%) of pre-transplant positive 26 patients had became negative in a mean of 24±28 months, and it took less than 5 years to become negative in 70% of them. Also, five patients had pre-transplant titers below 100 mIU/mL.  Pre-transplant Anti-HBs was negative in four patients(13.3%). After Hepatitis-B vaccination, the Anti-HBs became positive in three of them. However, on follow-up, it became negative again in two patients.

Conclusions:

After kidney transplantation, a decrease of Anti-HBs titers may be observed in recipients, especially in those with titers below 100 mIU/mL. Therefore, monitorization of the serologic responses, even after repetition of vaccine may be helpful.