Therapy With m-TOR Inhibitors Decreases the Response to the Pandemic Influenza A H1N1 Vaccine in Solid Organ Transplant Recipients

Authors

  • E. Cordero,

    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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    • These authors contributed equally to this work.

  • A. Perez-Ordoñez,

    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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    • These authors contributed equally to this work.

  • T. A. Aydillo,

    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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  • J. Torre-Cisneros,

    1. Clinic Unit of Infectious Diseases (JTC, RL) and Service of Cardiology, Maimonides Institute for Biomedical Research (IMIBIC) Reina Sofia University Hospital, University of Córdoba (UCO), Cordoba, Spain
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  • J. Gavalda,

    1. Vall d'Hebron University Hospital, Barcelona, Spain
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  • R. Lara,

    1. Clinic Unit of Infectious Diseases (JTC, RL) and Service of Cardiology, Maimonides Institute for Biomedical Research (IMIBIC) Reina Sofia University Hospital, University of Córdoba (UCO), Cordoba, Spain
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  • C. Segura,

    1. Clinic Unit of Infectious Diseases (JTC, RL) and Service of Cardiology, Maimonides Institute for Biomedical Research (IMIBIC) Reina Sofia University Hospital, University of Córdoba (UCO), Cordoba, Spain
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  • O. Len,

    1. Vall d'Hebron University Hospital, Barcelona, Spain
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  • E. Cabral,

    1. Vall d'Hebron University Hospital, Barcelona, Spain
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  • A. Gasch,

    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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  • J. Pachon,

    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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  • P. Perez-Romero

    Corresponding author
    1. Unit of Infectious Disease, Microbiology and Preventive Medicine, Institute of Biomedicine of Sevilla (IBiS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Sevilla, Spain
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  • Other authors in the pandemic vaccine in SOTR study group (REIPI): From University Hospital Virgen del Rocío: Martin-Gandul C, Martin-Peña A, Sobrino M, Suárez G, Gentil MA. From the University Hospital Reina Sofia: Salgueiro I, Vidal E, Arizón JM, Vaquero JM, Santos F, Redel J, Mendoza M, Rodríguez A, Agüera ML, de la Mata M, Barranco JL, Ostos C, Castro L. From Val d'hebron Hospital: Román A, Monforte V, Bilbao I, Castells L, Perelló M.

Perez-Romero, mariap.perez.exts@juntadeandalucia.es

Abstract

Concern has been raised regarding the response to vaccination in solid organ transplant recipients (SOTR) undergoing immunosuppressant regimens and the possibility of rejection related to the immune response associated with pandemic influenza H1N1–2009 vaccination. The goal of this study was to assess the immunogenicity, efficacy and safety of the pandemic vaccine in SOTR. We performed a multicenter prospective study in SOTR receiving the pandemic vaccine. Immunological response was determined in serum 5 weeks after vaccination by microneutralization assays, and immunoglobulins were measured by ELISA. Three hundred and forty-six SOTR were included. Preexisting seroprotection was detected in 13.6% of cases and rates of seroconversion and seroprotection after vaccination were 73.1% and 82.9%, respectively. Patients with baseline antibody titers had better geometric mean titers (GMT)-post after pandemic vaccination (339.4 vs. 121.4, p < 0.001). Younger age, liver disease and m-TOR inhibitor therapy were independently associated with lower seroprotection and GMT-post. There were no major adverse effects or rejection episodes. Pandemic vaccine was safe in SOTR and elicited an adequate response, although lower than in healthy individuals. This is the first study describing a decreased response after vaccination in patients receiving mTOR inhibitors who presented lower seroprotection rates and lower GMT-post.

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