Humoral and Cellular Immune Responses after Influenza Vaccination in Kidney Transplant Recipients
Candon S, Thervet E, Lebon P, Suberbielle C, Zuber J, Lima C, Charron D, Legendre C, Chatenoud L. Am J Transplant. 2009 Oct;9(10):2346-54
Influenza infection is associated with greater morbidity and mortality in the transplant population. Although annual influenza vaccination is
recommended for renal transplant recipients, there is a concern that vaccination may stimulate the immune system sufficiently to cause an immune response to the renal transplant. In this prospective observational study, vaccination did not result in production of donor-specific antibodies, although transplanted patients were less likely to develop anti-viral antibodies than control patients.
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Abstract:
It has been speculated that influenza vaccination of renal allograft recipients could be associated with de novo production and/or increased titers of anti-HLA antibodies (HLA-Ab). To directly address this issue, we recruited 66 stable renal transplant recipients and 19 healthy volunteers during the 2005-2006 vaccination campaign. At day 0 and day 30 following vaccination, HLA-Ab were screened and in parallel influenza-specific antibody and T-cell responses were assessed. Humoral postvaccinal responses to A/H1N1 and A/H3N2 strains, but not B strain, were less frequent in transplanted patients than in control subjects. Significant expansion of influenza-specific IFN-gamma-producing T cells was observed at similar frequencies in patients and controls. There was no correlation between cellular and humoral postvaccinal responses. No impact of sex, age or immunosuppressive regimen could be evidenced. Vaccination was not associated with any significant change in preexisting or de novo anti-HLA sensitization. No episode of allograft rejection was recorded in any of the patients. Our results suggest that flu vaccination is safe in stable renal transplanted patients. Larger studies are needed for definitive statistical proof of the safety and effectiveness, with regard to the quality of the immune response, of yearly influenza vaccination in immunosuppressed patients.
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