Methods: Retrospective data were collected to determine the durability of hepatitis B vaccination in pediatric renal transplant patients between October 1, 2004 to October 1, 2014. One hundred and two subjects (61% male) were categorized based on pre-transplant hepatitis B surface antibody (HBsAb).
Results: Pre-transplant, eighty-seven recipients (85%) had a positive HBsAb compared to fifteen (15%) with negative HBsAb. In univariable analyses, no significant differences existed pre-transplant by gender, body mass index (BMI), donor-type, pre-transplantation dialysis, or dialysis length (p <0.05). Of the eighty-seven pre-transplantation responders, fifty-three (61%) remained HBsAb positive post-transplantation, twenty-eight (32%) seroreverted to HBsAb negative, four developed indeterminate titers, and two did not have post-transplantation titers. In univariable analyses, a cadaveric donor type appeared protective for maintenance of HBsAb post-transplantation (p-value=0.005). No significant differences were found in gender, BMI, race, pre-transplantation dialysis, dialysis length, transplant type, HBV vaccination number, or transplantation rejection episodes (p<0.05). Further analysis revealed that all seroreversions occurred within 5 years post-transplant.
Conclusion: At the conclusion of the study period, 32% of the renal transplant recipients lost their HBV seroprotection. Therefore a moderate number of pediatric renal transplant recipients may be at risk for HBV infection. Multivariable analysis is in process to further evaluate durability of HBsAb post-transplant and post-immunization.
D. Hooper, None
D. Lazear, None
M. Lake, None
L. Danziger-Isakov, None