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• W1575626200 abstract "We thank L’Huillier and colleagues for their letter and thoughtful review of our Brief Communication (1.L’Huillier AG McLin VA Posfay-Barbe KM Hepatitis B virus immunization before and after pediatric liver transplantation: Check, catch-up, and check again!.Am J Transplant. 2015; 15: 2275-2276Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar,2.Leung D Ton-That M Economides J Healy CM High prevalence of HBV non-immunity in vaccinated pediatric liver transplant recipients.Am J Transplant. 2015; 15: 535-540Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar). We agree and support their statement that although antibody waning may be unavoidable after liver transplantation, close monitoring of serological markers for protection is likely beneficial in ensuring optimal protection. This is one of the conclusions of our study. However, although we are aware of the previously published recommendations referenced (3.Danziger-Isakov L Kumar D Vaccination in solid organ transplantation.Am J Transplant. 2013; 13: 311-317Abstract Full Text Full Text PDF PubMed Scopus (176) Google Scholar,4.Danzinger-Isakov L Kumar D Guidelines for vaccination of solid organ transplant candidates and recipients.Am J Transplant. 2009; 9: S258-S262Abstract Full Text Full Text PDF PubMed Scopus (156) Google Scholar) we note that our study was a point prevalence study of patients performed during 2011–2012. The majority of our cohort had also been transplanted some years prior to our study (mean time since transplant was 4.6 years). Prior to the release of these recommendations, we instituted a protocol of regular serological monitoring for both pre– and post–liver transplant patients with administration of booster doses of vaccine when titers are nonprotective, and look forward to analyzing short and long-term outcomes of HBV immunity in this cohort of children. One of the acknowledged limitations of our study is the inability of our design to determine primary immunization failure versus antibody waning. This distinction, however, will be apparent under our current monitoring schedule. However, one could postulate that our cohort is similar in that regard with the cohort reported from the national reference center in Switzerland (5.L’Huillier AG Wildhaber BE Belli DC Diana A Rodriguez M Siegrist CA Successful serology-based intervention to increase protection against vaccine-preventable diseases in liver-transplanted children: A 19 year review of the Swiss national reference center.Pediatr Transplant. 2012; 16 (et al): 50-57Crossref PubMed Scopus (29) Google Scholar) who have had pre- and posttransplant serological monitoring incorporated as standard of care since 2003. In both studies, more than 60% of patients were nonimmune posttransplant although many of our cohort were longer posttransplant than the 1-year data reported from the Swiss cohort. It is also encouraging that so many Swiss patients responded to booster vaccination. Nevertheless, defining clinical factors, markers of functional cellular, humoral immunity that may predict poor immune function, suboptimal response to immunization, rapid antibody waning in transplant recipients merits further study, ideally in a multicenter fashion. The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. Dr. Healy has received research grants from Sanofi Pasteur and Novartis Vaccines and served on Scientific Advisory Boards for Novartis Vaccines and Pfizer, Inc. Other authors have no conflicts of interest to disclose." @default.
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• W1575626200 date "2015-08-01" @default.
• W1575626200 modified "2023-10-10" @default.
• W1575626200 title "Reply to L’Huillier et al" @default.
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• W1575626200 doi "https://doi.org/10.1111/ajt.13311" @default.
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