Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis
<p>Background: Clinical guidelines recommend vaccinations for solid-organ transplant recipients. However, concern exists that vaccination may stimulate adverse alloimmune responses.</p><p> Methods: We systematically reviewed the published literature regarding this aspect of vaccin...
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| Format: | Journal article |
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Elsevier
2018
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| _version_ | 1826306351704309760 |
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| author | Mulley, W Dendle, C Ling, JX Knight, SR |
| author_facet | Mulley, W Dendle, C Ling, JX Knight, SR |
| author_sort | Mulley, W |
| collection | OXFORD |
| description | <p>Background: Clinical guidelines recommend vaccinations for solid-organ transplant recipients. However, concern exists that vaccination may stimulate adverse alloimmune responses.</p><p> Methods: We systematically reviewed the published literature regarding this aspect of vaccine safety. Electronic databases were searched for interventional and observational studies assessing de novo donor-specific antibodies (DSA) and rejection episodes after vaccination against infectious pathogens. Graft loss was also assessed. A meta-analysis was conducted for prospective, controlled studies. PRISMA reporting guidelines were followed.</p><p> Results: Ninety studies (15,645 vaccinated patients and 42,924 control patients) were included. Twelve studies included control groups. The incidence of de novo DSA (14 studies) was 23 of 1,244 patients (1.85%) at 21 to 94 days. The incidence of rejection (83 studies) was 107 episodes in 5,116 patients (2.1%) at 0.7 to 6 months. Meta-analysis of prospective controlled studies (n = 8) showed no increased rejection risk with vaccination compared with no vaccination (RR 1.12, 95% CI 0.75 to 1.70). This finding was supported by data from 3 registry analyses.</p><p> Conclusions: Although the current evidence lacks high-quality, controlled studies, the currently available data provide reassurance that clinicians should recommend appropriate vaccination for their transplant patients as the risk of de novo DSA and rejection is relatively low.</p> |
| first_indexed | 2024-03-07T06:46:39Z |
| format | Journal article |
| id | oxford-uuid:fb131d7e-0f2d-4901-bb85-51431bba0f48 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T06:46:39Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:fb131d7e-0f2d-4901-bb85-51431bba0f482022-03-27T13:11:06ZDoes vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fb131d7e-0f2d-4901-bb85-51431bba0f48Symplectic Elements at OxfordElsevier2018Mulley, WDendle, CLing, JXKnight, SR<p>Background: Clinical guidelines recommend vaccinations for solid-organ transplant recipients. However, concern exists that vaccination may stimulate adverse alloimmune responses.</p><p> Methods: We systematically reviewed the published literature regarding this aspect of vaccine safety. Electronic databases were searched for interventional and observational studies assessing de novo donor-specific antibodies (DSA) and rejection episodes after vaccination against infectious pathogens. Graft loss was also assessed. A meta-analysis was conducted for prospective, controlled studies. PRISMA reporting guidelines were followed.</p><p> Results: Ninety studies (15,645 vaccinated patients and 42,924 control patients) were included. Twelve studies included control groups. The incidence of de novo DSA (14 studies) was 23 of 1,244 patients (1.85%) at 21 to 94 days. The incidence of rejection (83 studies) was 107 episodes in 5,116 patients (2.1%) at 0.7 to 6 months. Meta-analysis of prospective controlled studies (n = 8) showed no increased rejection risk with vaccination compared with no vaccination (RR 1.12, 95% CI 0.75 to 1.70). This finding was supported by data from 3 registry analyses.</p><p> Conclusions: Although the current evidence lacks high-quality, controlled studies, the currently available data provide reassurance that clinicians should recommend appropriate vaccination for their transplant patients as the risk of de novo DSA and rejection is relatively low.</p> |
| spellingShingle | Mulley, W Dendle, C Ling, JX Knight, SR Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title | Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title_full | Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title_fullStr | Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title_full_unstemmed | Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title_short | Does vaccination in solid organ transplant recipients result in adverse immunological sequelae? a systematic review and meta-analysis |
| title_sort | does vaccination in solid organ transplant recipients result in adverse immunological sequelae a systematic review and meta analysis |
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