Clinical Epidemiology and Ageing

Infectious disease consultation is effective in boosting vaccine coverage in patients awaiting kidney transplantation: A French prospective study.

Runyo F, Matignon M, Audureau E, Vindrios W, Boueilh A, Gomart C, Grimbert P, Gallien S, Melica G Transpl Infect Dis. 2021;23(4):e13607.

Recommended preventive strategies before kidney transplantation include screening and treatment of latent tuberculosis infection (LTBI), and updating of the recommended vaccines. We prospectively evaluated in dedicated infectious diseases consultations, from 2014 to 2018, the clinical and vaccination data of new adult kidney allograft candidates. Patients were offered an updated vaccination schedule, if appropriate, and were screened for LTBI using chest imaging and interferon gamma release assay (IGRA). Overall, 467 patients with median age of 58 [46-66] years were evaluated, of whom 302 patients (65%) were men (sex ratio 1.83), and 333 (71%) were on dialysis. Main causes of renal insufficiency were diabetes (25%) and autoimmune nephropathies (18%). The vaccination coverage was low and varied according to the different types of vaccines and patients. Vaccination or immunization rates were 24%, 6%, 54%, and 51% for tetanus-diphtheria-polio-acellular pertussis, Pneumococcus, hepatitis B, and seasonal influenza, respectively. ID consultation successfully rose patients' vaccinations coverage, in fulfillment with recommendations, in 465 (99%) patients. LTBI treatment was administered in 78 (16.7%) patients and caused drug-related adverse events in 9 (11%). A dedicated infectious disease consultation should become a critical tool for coordinating infection prevention strategies.

MeSH terms: Adult; Aged; Hepatitis B; Humans; Immunization Schedule; Kidney Transplantation; Male; Middle Aged; Prospective Studies; Referral and Consultation; Tetanus Toxoid; Vaccination
DOI: 10.1111/tid.13607