Risk factors for loss of Varicella immunity after pediatric kidney transplantation.
Background: Varicella zoster (VZV) vaccination pre-kidney transplant (Tx) can help prevent severe disseminated VZV in immunosuppressed recipients; however, studies have shown loss of humoral immunity post-Tx. Methods: A retrospective analysis of 45 pediatric kidney Tx recipients with positive pre-Tx...
| Published in: | Pediatric Nephrology Vol. 41; no. 3; pp. 837 - 845 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts Journal Article |
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Springer Nature
Mar2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191207219&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191207219 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Mar2026 vid: 41 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 191207219 189251459 191207219 191207219 10.1007/s00467-025-07022-7 191207219 ppf: 837 ppct: 8 formats: tig: atl: Risk factors for loss of Varicella immunity after pediatric kidney transplantation. aug: au: Pizzo, Helen Soni, Priya R. Nadipuram, Santhosh Mirocha, James Garrison, Jonathan Hilario, Sherlyn Puliyanda, Dechu affil: https://ror.org/02pammg90 Cedars-Sinai Medical Center Guerin Children's, 8700 Beverly Blvd., 90048, Los Angeles, CA, USA sug: subj: Kidney Transplantation In Infancy and Childhood Chickenpox Risk Factors Herpes Zoster Risk Factors Chickenpox Immunology Herpes Zoster Immunology Immunity Risk Assessment Human Child Adolescence Male Female Funding Source Retrospective Design Record Review Nonexperimental Studies Descriptive Statistics Immunosuppression Antibodies Confidence Intervals Immunization Seroconversion Mycophenolate Mofetil Tacrolimus Immunoenzyme Techniques Serology Wilcoxon Rank Sum Test Fisher's Exact Test Kaplan-Meier Estimator Log-Rank Test Cox Proportional Hazards Model Data Analysis Software Chickenpox Vaccine Administration and Dosage Herpes Zoster Vaccine Administration and Dosage Immunoglobulins Child: 6-12 years Adolescent: 13-18 years Male Female ab: Background: Varicella zoster (VZV) vaccination pre-kidney transplant (Tx) can help prevent severe disseminated VZV in immunosuppressed recipients; however, studies have shown loss of humoral immunity post-Tx. Methods: A retrospective analysis of 45 pediatric kidney Tx recipients with positive pre-Tx VZV IgG (>1.09 index). VZV IgG was assessed annually and compared with the induction agent used, the number of VZV vaccines received, and the interval between the last dose of VZV vaccine and Tx. Results: Median age at Tx was 16.7 years (IQR 12.7–18.5). 11 of 45 (24.4%) patients lost immunity to VZV at a median of 12.6 months post-Tx. Those who lost VZV immunity were younger at the time of Tx, 12.4 years vs. 17.3 years (P = 0.05) and more likely to be on steroid-based immunosuppression 81.8% vs. 32.4% (P = 0.006). There were no differences between the induction agents used and the ability to maintain VZV IgG antibodies. Subjects who required ≥3 doses of VZV vaccine to develop VZV IgG seropositivity were at a higher risk for losing their anti-varicella antibody post-Tx (HR 3.81, 95% CI 1.09–13.30, P = 0.04). Receiving VZV vaccination <1 year prior to kidney Tx was associated with a higher risk for losing anti-varicella antibody after Tx (HR 6.97, 95% CI 2.08–23.34). Conclusion: In this small cohort, pediatric kidney Tx recipients are more likely to lose VZV IgG in those who were younger at the time of Tx, on steroid-based immunosuppression, required 3 or more doses of VZV vaccination to seroconvert, or received VZV vaccine <1 year before Tx. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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