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Immunization after renal transplantation: current clinical practice.

G H Struijk1, A J J Lammers, R J Brinkman

  • 1Renal Transplant Unit, Department of Nephrology, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
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PubMed
Summary

Vaccination rates for renal transplant recipients (RTR) are suboptimal, with nephrologists showing low adherence to guidelines. While RTR are aware of infection risks, their behavior doesn't align, highlighting the need for better nephrologist counseling.

Keywords:
barriersguideline adherenceimmunizationinfectionrenal transplantation

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Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Infectious Diseases

Background:

  • Renal transplant recipients (RTR) face increased infection risk due to immunosuppression and travel.
  • Kidney Disease: Improving Global Outcomes (KDIGO) guidelines exist for post-transplant vaccination.
  • Adherence to KDIGO vaccination guidelines among RTR and associated barriers are largely unknown.

Purpose of the Study:

  • To assess Dutch nephrologists' vaccination policies and adherence to KDIGO guidelines.
  • To evaluate awareness and attitudes of RTR regarding infection risks.
  • To identify barriers to guideline adherence.

Main Methods:

  • Cross-sectional national survey of Dutch nephrologists (n=132).
  • Cross-sectional survey of RTR (n=403) in an outpatient clinic.
  • Assessed vaccination rates, guideline familiarity, and risk perception.

Main Results:

  • Low immunization rates for pneumococcal, tetanus, and meningococcal vaccines.
  • Only 27% of nephrologists were familiar with KDIGO guidelines; perceived low effectiveness was a barrier.
  • RTR awareness of infection risk correlated with education level, but behavior did not match awareness.

Conclusions:

  • Nephrologists' knowledge and adherence to post-transplant immunization recommendations are suboptimal.
  • RTR acknowledge increased infection risks, but this awareness is not reflected in their actions.
  • Nephrologists play a crucial role in counseling RTR to improve vaccination behavior.