2025 Volume 13 Issue 1 Pages 50-55
Kidney transplant recipients are at high risk of infection because they continue to receive multiple immunosuppressive agents. Therefore, it is necessary for them to receive as many vaccinations as possible before kidney transplantation. Inactivated vaccines such as pneumococcal, influenza, and hepatitis B are necessary, and all of these are included in the routine vaccinations for infants, so we have to check that these vaccines are completed before kidney transplantation. For hepatitis B, an additional vaccination is required if HBs antibody is negative. Kidney transplant recipients cannot discontinue immunosuppressive agents and the package insert states that live vaccines are contraindicated with immunosuppressive agents. So, it is best to administer live vaccines such as measles-rubella vaccine, chickenpox vaccine, and mumps vaccine repeatedly before kidney transplantation until antibody titers are sufficiently high (EIA-IgG 10.0 or higher). Currently, there are reports that live vaccines are effective and safe even under immunosuppressive agents, if the immunological parameters are in certain levels, and social systems for administration of live vaccines after kidney transplantation have to be constructed in the future.
