2340. Durability of the Hepatitis B Seroprotection in Pediatric Renal Transplant Recipients
Session: Poster Abstract Session: Transplant Virology
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • ID Week poster.pdf (924.3 kB)
  • Background: Hepatitis B virus (HBV) is known to cause hepatic failure and hepatocellular carcinoma; however since vaccination availability, the incidence of HBV has significantly decreased. Despite adequate vaccination, studies in adult renal transplant recipients show a higher loss of HBV titers post-transplant compared to that of the general population.

    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.

    Hilary Miller-Handley, MD, Grant Paulsen, MD, David Hooper, MD, MS, Danielle Lazear, Pharm D, Michael Lake, MA and Lara Danziger-Isakov, MD, MPH, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

    Disclosures:

    H. Miller-Handley, None

    G. Paulsen, None

    D. Hooper, None

    D. Lazear, None

    M. Lake, None

    L. Danziger-Isakov, None

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