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Under-Vaccination in Pediatric Liver Transplant Candidates with Acute and Chronic Liver Disease-A Retrospective Observational Study of the European Reference Network TransplantChild

GND
1078003696
ORCID
0009-0003-3784-1444
Affiliation
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Laue, Tobias;
ORCID
0000-0003-1972-8213
Affiliation
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Demir, Zeynep;
ORCID
0000-0002-0345-963X
Affiliation
Pediatric Hepatology Unit, Necker Enfants Malades Hospital, 75015 Paris, France
Debray, Dominique;
ORCID
0000-0002-7177-2847
Affiliation
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Cananzi, Mara;
Affiliation
Unit of Paediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, University Hospital of Padova, 35142 Padova, Italy
Gaio, Paola;
ORCID
0000-0002-8951-7836
Affiliation
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
Casotti, Valeria;
GND
1188894374
ORCID
0000-0001-7150-3148
Affiliation
Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
D'Antiga, Lorenzo;
ORCID
0000-0002-7779-5484
Affiliation
Clinic of Children's Diseases, Vilnius University Faculty of Medicine, 08406 Vilnius, Lithuania
Urbonas, Vaidotas;
GND
1016005113
Affiliation
Department of Paediatric Liver, Kidney and Metabolic Diseases, Division of Paediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany
Baumann, Ulrich

Infection is a serious concern in the short and long term after pediatric liver transplantation. Vaccination represents an easy and cheap opportunity to reduce morbidity and mortality due to vaccine-preventable infection. This retrospective, observational, multi-center study examines the immunization status in pediatric liver transplant candidates at the time of transplantation and compares it to a control group of children with acute liver disease. Findings show only 80% were vaccinated age-appropriately, defined as having received the recommended number of vaccination doses for their age prior to transplantation; for DTP-PV-Hib, less than 75% for Hepatitis B and two-thirds for pneumococcal conjugate vaccine in children with chronic liver disease. Vaccination coverage for live vaccines is better compared to the acute control group with 81% versus 62% for measles, mumps and rubella (p = 0.003) and 65% versus 55% for varicella (p = 0.171). Nevertheless, a country-specific comparison with national reference data suggests a lower vaccination coverage in children with chronic liver disease. Our study reveals an under-vaccination in this high-risk group prior to transplantation and underlines the need to improve vaccination.

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