Pneumococcal disease in adult solid organ transplantation recipients

Table 2 Pneumococcal vaccination studies in kidney transplantation in adult recipients

Ref.	N	Time since transplant	Vaccine	Technique	Response to immunization	Long term immune response
Silberman et al[59]	27 KT vs 24 healthy adults	7-108 mo	14-valent	Indirect hemagglutination	4-fold increase in titers, equivalent to controls	Not studied
Marrie et al[60]	63 KT vs 8 healthy adults	3-99 mo	14-valent	RIA	2.8-fold increase in titers in KT vs 3.4-fold in controls	GMT in KT: 872 ng N/mL post-vaccine 659 ng N/mL at 12 mo
Cosio et al[61]	25 KT (14 asplenia) vs 14 healthy adults	3-118 mo	14-valent	RIA	2-fold increase in titers in 93% of 14 healthy adults vs 78% of 14 splenectomized KT and 55% of 11 non-splenectomized KT patients	Not studied
Linneman et al[62,63]	104 KT (79 asplenia) vs 33 patients in hemodialysis	No data	14-valent	RIA	1.4-fold increase in antibody titers: 91%GMT post-vaccine with lower response in splenectomized KT vs non-splenectomized KT patients (394 vs 626 ng N/mL, P < 0.05) GMT post-vaccine with lower response in KT patients before 6 mo after transplant vs hemodialysis patients (303 vs 592 ng N/mL, P < 0.05)	GMT at 24 mo in 33 KT: 932 ng N/mL post-vaccine 385 ng N/mL at 24 mo 536 ng N/mL at revaccination
Arnold et al[64]	75 KT (32 asplenia) vs 60 healthy controls	> 12 mo	14-valent	Serum opsonizing antibody	2-fold increase in titers to serotypes 12F and 14 No differences in splenectomized vs non-splenectomized KT recipients	Not studied
Rytel et al[65]	61 KT (57 asplenia) vs 23 patients in dialysis vs 9 healthy controls	> 6 mo	14-valent	RIA	Equivalent protective GMT titers vs controls	Equivalent at 1, 2, and 3.5 yr vs controls
Kazancioglu et al[69]	21 KT vs 25 healthy controls	> 2 mo	PPV23	ELISA	Protective response to vaccination (40% increases in the antibody concentration) in 95.2% of KT at 1.5 and 3 mo after vaccination	Not studied
Kumar et al[78,79]	30 KT (PPV23) vs 30 KT (PCV7)	3 mo-3 yr	PPV23 vs PCV7	ELISA, OPA	Response to at least 1 serotype: no significant differences in antibody titers between PPV23 and PVC7, both using ELISA (53.3% vs 73.3%) and OPA (83.3% vs 80%)	Vaccine responses decline significantly after 3 yr and conjugate vaccine does not improve the durability of response

KT: Kidney transplantation; PPV23: 23-valent pneumococcal polysaccharide vaccine; PCV7: 7-valent pneumococcal conjugate vaccine; RIA: Radioimmunoassay; ELISA: Enzyme-Linked ImmunoSorbent Assay; OPA: Opsonophagocytic assay; GMT: Geometric Mean Titer.