Vaccine Preventable Infections Common After Pediatric Organ Transplantation Interview with:

Amy G. Feldman, MD, MSCS Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition Program Director, Liver Transplant Fellowship Children's Hospital Colorado  University of Colorado Medicine

Dr. Feldman

Amy G. Feldman, MD, MSCS
Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition
Program Director, Liver Transplant Fellowship
Children’s Hospital Colorado
University of Colorado Medicine What is the background for this study? What are the main findings?

Response: Pediatric solid organ transplant recipients are at increased risk for vaccine preventable infections due to life-long immunosuppressive medications.  The objectives of this study were to 1) evaluate in pediatric    solid organ transplant recipients the number of hospitalizations for vaccine-preventable infections in the first five years post-transplantation and 2) determine the associated morbidity, mortality and costs.

In this multicenter cohort study of 6980 children who underwent solid organ transplantation from January 1, 2004, to December 31, 2011, at a center participating in Pediatric Health Information System (PHIS), 15% of individuals had at least 1 hospitalization for a vaccine-preventable infection in the first 5 years after transplant.  Children who received transplants when they were younger than 2 years and recipients of lung, intestine, heart, and multi-visceral organs were at increased risk for hospitalization with a vaccine-preventable infection.  Transplant hospitalizations complicated by a vaccine-preventable infection were $120,498 more expensive (median cost) and were on average 39 days longer than transplant hospitalizations not complicated by vaccine-preventable infections What should readers take away from your report?

Response: Vaccine preventable infections are a common occurrence after pediatric solid organ transplantation and result in significant morbidity, mortality, and increased costs.  This study demonstrates the importance of fully immunizing all transplant candidates and recipients. What recommendations do you have for future research as a result of this work? 

Response: Future research is necessary to

1)  understand barriers to immunization of pediatric transplant candidates and recipients,

2)  develop tools to improve immunization delivery in the transplant population,

3) improve practices to prevent nosocomial infectious spread post-transplantation, and

4) establish best methods to monitor immune response to vaccines pre- and post-transplant. Is there anything else you would like to add?

Response: Dr. Feldman was supported by a Children’s Hospital Colorado Research Institute Research Scholar Award and the National Institutes of Health/National Center for Advancing Translational Sciences Colorado CTSA Grant Number KL2 TR002534. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.


Feldman AG, Beaty BL, Curtis D, Juarez-Colunga E, Kempe A. Incidence of Hospitalization for Vaccine-Preventable Infections in Children Following Solid Organ Transplant and Associated Morbidity, Mortality, and Costs. JAMA Pediatr. Published online January 14, 2019. doi:10.1001/jamapediatrics.2018.4954






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