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Successful serology-based intervention to increase protection against vaccine-preventable diseases in liver-transplanted children: A 19-yr review of the Swiss national reference center

Authors


Klara Posfay-Barbe, MD, MS, Children’s Hospital of Geneva, 6, rue Willy-Donzé, 1211 Geneva 14, Switzerland
Tel.: +41 22 382 5462
Fax: +41 22 382 5490
E-mail: klara.posfaybarbe@hcuge.ch

Abstract

L’Huillier AG, Wildhaber BE, Belli DC, Diana A, Rodriguez M, Siegrist CA, Posfay-Barbe KM. Successful serology-based intervention to increase protection against vaccine-preventable diseases in liver-transplanted children: A 19-yr review of the Swiss national reference center.
Pediatr Transplantation 2012: 16: 50–57. © 2011 John Wiley & Sons A/S.

Abstract:  As children referred for OLT in Switzerland were not vaccinated optimally, new guidelines were developed and recommended to base catch-up immunization on serum antibody titers against vaccine-preventable diseases, before and after OLT. We measure the results of this serology-based intervention by comparing vaccine coverage and antibody titers in the pre- (1990–2002, P1) and post-intervention (2003–2008, P2) cohorts in a quality control project. Forty-four P1 and 30 P2 children were evaluated. At pre-OLT visit, D, T, SPn, and MMR serologies were checked more frequently in P2 than P1 (p < 0.05). More P2 children were up-to-date for DTaP and MMR (p < 0.05) or had received ≥1 dose of HBV, HAV, SPn, and VZV vaccines (p < 0.05). One yr post-OLT, DT, SPn, MMR, and VZV serologies were more frequently checked (p < 0.05), and antibody titers were higher for DT and HAV (p < 0.05) in P2. Gender, age, or diagnosis did not explain these differences. Among P2 patients, pre- and post-OLT titers for D, T, Hib, HBV, SPn14, and SPn19 were correlated (p < 0.05 for all). Protection against vaccine-preventable diseases of high-risk children like OLT patients can be significantly improved by serology-based intervention for vaccine-preventable diseases.

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