Related Experiment Video
Updated: Apr 28, 2026
In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
B-sides serologic markers of immunogenicity in kidney transplanted patients: report from 2012-2013 flu vaccination
Stefano Rinaldi1, Alberto Cagigi, Veronica Santilli
11 Department of System Medicine, University of Rome, Tor Vergata, Rome, Italy. 2 University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children's Hospital, Rome, Italy. 3 WHO National Influenza Centre, Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy. 4 National Council of Researches IFT Unit of Rome S. Camillo Hospital, Regional Transplant Center Lazio (CRTL), S. Camillo Hospital, Rome, Italy. 5 Pediatric Medicine and Infectious Disease, Pediatrics Medicine Department, Bambino Gesù Children's Hospital, Roma, Italy. 6 Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Rome, Italy. 7 Address correspondence to: Paolo Palma, M.D., Ph.D., University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy and Luca Dello Strologo, M.D., Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy.
Background:
Safety and immunogenicity data of seasonal influenza vaccination in transplanted patients (Tps) are controversial. Preexisting cross-reactive antibodies generated by repeated vaccination with drift variant strains could bias interpretation of immunogenicity data in Tp.
Methods:
The unadjuvanted 2012-2013 seasonal influenza vaccine was administered to 81 kidney Tps being routinely vaccinated against influenza and 23 healthy controls (HCs). Immunogenicity was evaluated by both strain-specific antibody responses with standard hemagglutination inhibition assay and by memory B-cell enzyme-linked immunosorbent spot. Safety was also evaluated by measuring anti-human leukocyte antigen (HLA) antibodies.
Results:
The majority of Tps were seroprotected before vaccination (81.5%, 81.5%, and 43.2% vs. 47.8%, 34.8%, and 30.4% in HC for H1N1, H3N2, and B strain, respectively) resulting into lower seroconversion rates (P≤0.01) as compared with HC (40.7%, 39.5%, and 54.3% vs. 73.9%, 82.6%, and 65.2% for H1N1, H3N2, and B strain, respectively). An inverse correlation was found between seroconversion rates and number of previous vaccinations in Tps. On the contrary, similar increase in the frequencies of strain-specific memory B cells were detected by B-cell enzyme-linked immunosorbent spot in both Tps and HCs after vaccination. No serious adverse events have been reported. Donor-specific HLA antibodies increased in two patients after vaccination, and de novo anti-HLA antibodies were identified in two additional patients (non-donor-specific HLA antibodies).
Conclusion:
This report on safety and immunogenicity of the seasonal unadjuvanted 2012-2013 flu vaccination suggests that evaluating immunogenicity of influenza vaccination exclusively by hemagglutination inhibition assay may be misleading in individuals receiving yearly seasonal vaccines. Further investigations are required to understand the relation between vaccination and anti-HLA antibody development.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:24Serum Studies: Renal Function Tests