Efficacy and safety of measles, mumps, rubella and varicella live viral vaccines in transplant recipients receiving immunosuppressive drugs
Efficacy and safety of measles, mumps, rubella and varicella live viral vaccines in transplant recipients receiving immunosuppressive drugs
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麻疹、腮腺炎、风疹和水痘活病毒疫苗对接受免疫抑制药物的移植受者的功效和安全性
DOI：
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发表时间：
2008
影响因子：
8.7
通讯作者：
Joan L. Robinson
中科院分区：
文献类型：
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作者：
Angela Marie Danerseau;Joan L. Robinson
背景本综述旨在总结已发表的关于麻疹、腮腺炎、风疹或水痘活病毒疫苗在目前接受免疫抑制治疗的移植后患者中的有效性和安全性的数据。数据来源Medline、EMBASE和循证医学综述检索了1966年至2007年11月描述麻疹、腮腺炎、风疹、水痘活减毒疫苗有效性和/或安全性的病例报告或研究。或水痘疫苗在儿童中的免疫抑制后，实体器官，骨髓或干细胞transplantation.ResultsThe审查确定了6个病例系列和2个病例报告，描述了114个实体器官移植受体和一个病例系列，描述了27个骨髓移植受体，他们接受了总共206剂活水痘，麻疹，腮腺炎，或风疹疫苗。在单次接种疫苗后测定的171种情况中，有109种情况（64%）的免疫后滴度在免疫范围内，在2次接种后测定的22种情况中，有15种情况（68%）在免疫范围内。有没有重大的安全性问题，在这个小sample.ConclusionThere没有足够的已发表的数据，以获得以证据为基础的指导方针，使用活病毒疫苗在移植受者的免疫抑制，但初步数据的有效性和安全性表明，使用这些活病毒疫苗在移植受者仍然对免疫抑制可能是一个合理的策略。
BackgroundThis review was designed to summarize published data on the efficacy and safety of live viral vaccines for measles, mumps, rubella, or varicella in post-transplant patients currently on immunosuppression.Data sourcesMedline, EMBASE and Evidence Based Medicine Reviews were searched from 1966 to November 2007 for case reports or studies describing the efficacy and/or safety of live attenuated measles, mumps, rubella, or varicella vaccine in children on immunosuppression following solid organ, bone marrow or stem cell transplantation.ResultsThe review identified 6 case series and 2 case reports describing 114 solid organ transplant recipients and one case series describing 27 bone marrow transplant recipients who had received a combined total of 206 doses of live varicella, measles, mumps, or rubella vaccine while on immunosuppression. Post-immunization titers were in the immune range in 109 of the 171 situations where they were measured following a single dose of vaccine (64%) and in 15 of 22 situations following 2 doses (68%). There were no major safety concerns in this small sample.ConclusionThere are insufficient published data to derive evidence-based guidelines for use of live viral vaccines in transplant recipients on immunosuppression but preliminary data on efficacy and safety suggest that the use of these live viral vaccines in transplant recipients still on immunosuppression could be a reasonable strategy.