Recipients of solid-organ transplantation are at risk of severe infections due to their life-long immunosuppression. Despite emerging evidence that vaccinations are safe and effective among immunosuppressed patients, most vaccines are still underutilized in these patients. The efficacy, safety, and protocols of several vaccines in this patient population are poorly understood. Timing of vaccination appears to be critical because response to vaccinations is decreased in patients with end-stage organ disease and in the first 6 months after transplantation. For these reasons, the primary immunizations should be given before transplantation, as early as possible during the course of disease. Vaccination strategy should include vaccination of household contacts and health care workers at transplant centers unless contraindicated. No conclusive data are available on the use of immunoadjuvants and screening for protective titers. Most vaccines appear to be safe in solid-organ transplantation recipients, but live vaccines should be avoided until further studies are available. The risk of rejection appears minimal. Recommended vaccines include pneumovax, hepatitis A and B, influenza, and tetanus-diphtheria. We outline specific protocols and recommendations in this particular patient population. Specific contraindications exist for other vaccines, such as yellow fever, oral polio vaccine, bacillus Calmette-Guerin, and vaccinia. We conclude that solid-organ recipients will benefit from consistent immunization practices. Further studies are recommended to improve established protocols in this patient population.

中文翻译：

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成人实体器官移植受者的疫苗接种：当前建议和方案。


实体器官移植受者由于终生免疫抑制而面临严重感染的风险。尽管有新的证据表明疫苗接种在免疫抑制患者中是安全有效的，但大多数疫苗在这些患者中仍未得到充分利用。对于该患者群体中几种疫苗的功效、安全性和方案知之甚少。疫苗接种的时机似乎至关重要，因为患有终末期器官疾病的患者以及移植后的前 6 个月内对疫苗接种的反应会降低。由于这些原因，初次免疫接种应在移植前进行，并在病程期间尽早进行。疫苗接种策略应包括对家庭接触者和移植中心的医护人员进行疫苗接种，除非有禁忌症。没有关于免疫佐剂的使用和保护滴度筛选的结论性数据。大多数疫苗似乎对实体器官移植受者是安全的，但在进一步研究之前应避免使用活疫苗。被拒绝的风险似乎很小。推荐的疫苗包括肺炎疫苗、甲型和乙型肝炎疫苗、流感疫苗和破伤风白喉疫苗。我们概述了针对这一特定患者群体的具体方案和建议。其他疫苗也有特定的禁忌症，例如黄热病疫苗、口服脊髓灰质炎疫苗、卡介苗和牛痘疫苗。我们的结论是，实体器官接受者将受益于持续的免疫接种实践。建议进一步研究以改进该患者群体的既定方案。