Panel Reactive Antibody Responses Against Influenza Vaccination in Kidney Transplant Recipients.

Abstract

Introduction. Seasonal influenza is an important cause of morbidity and mortality in thepost-transplant period; therefore, the influenza vaccination has been recommended for allkidney transplant recipients before the influenza season. However, at least theoretically,the introduction of antigens via vaccines may trigger rejection attacks by causing anantibody response. In this study, we examined the development of de novo panelreactive antibody (PRA) development against the influenza vaccine in kidney transplantrecipients.Materials and Methods. Overall, 41 kidney transplant recipients who received theinfluenza vaccination and 50 kidney transplant recipients (study group) who refused toreceive the influenza vaccination (control group) were enrolled in the study. Followingbasal biochemistry examination, the inactivated trivalent influenza vaccine was administeredintramuscularly. Panel reactive antibodies were screened in all patients before andafter vaccination on days 30 and 180. The primary outcome variable was development of denovo panel reactive antibodies.Results. One patient in the study group developed de novo class I and II PRA at 6months after vaccination (P > .05), while no antibody development was noted in thecontrol group. Graft dysfunction or biopsy-confirmed rejection was not observed during thefollow-up period in both groups.Conclusion. The influenza vaccination is generally effective and safe in solid organtransplant recipients. The vaccination procedure has the potential to trigger antibodydevelopment and occurrence of rejection. Therefore, vaccinated kidney transplant recipientsshould be monitored more carefully with regard to PRA; if the graft deteriorates, arapid transplant biopsy should be performed.