Skip to main content
Log in

Attenuated varicella virus vaccine in children with renal transplants

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

The long-term efficacy of varicella vaccine was studied in 34 children aged 2–18 years who were either on chronic dialysis (n=17) or were renal transplant recipients (n=17). Live attenuated virus (OKA line) was inoculated in a single 0.5-ml subcutaneous dose, without modification of the immunosuppressive therapy protocol for renal transplant recipients. The majority of children (85%) developed antibodies within the first 6 months, with IgG titres (enzyme-linked immunosorbent assay) greater than 1∶40 (geometric mean 1∶640). Of those children who were followed for longer than 2 years, 76% maintained their antibody titres. Reactions to the vaccine were minimal and the immunological protection was effective. Only 3 children developed a mild form of varicella in the post-vaccination period. We consider that seronegative children who are candidates for renal transplantation must be protected against varicella by attenuated varicella vaccination. When vaccination is performed after transplantation, no modification of immunosuppressive therapy is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Feldman S, Hughes T, Daniel CB (1975) Varicella in children with cancer: seventy-seven cases. Pediatrics 56:388–397

    Google Scholar 

  2. Lobut JP, Michon J, Lemerle S, Bouvet E, Foulon G (1989) Fréquence de la varicelle chez lénfant immunodérpimé. Arch Fr Pediatr 46: 77–80

    Google Scholar 

  3. Balfour HH (1984) Intravenous acyclovir therapy for varicella in immunocompromised children. J Pediatr 104: 134–136

    Google Scholar 

  4. Whitley R, Hilty M, Haynes R, Bryson Y, Connor JD, Soong SJ, Alford CA (1982) Vidarabine therapy of varicella in immunosuppressed patients. J Pediatr 101:125–131

    Google Scholar 

  5. Schulman SL, Deforest A, Fisher MC, Kaiser B, Polinsky M, Baluarte HJ (1992) Varicella: effect of the disease and therapy on pediatric renal transplant recipients. Am J Kidney Dis 19: A12

    Google Scholar 

  6. Le Guen E, Deminiere C, Larue JR, Postec E, Morel D, Aparicio M, Potaux L (1992) Fatal varicella or Reye's syndrome: an unusual cause of death in a renal graft recipient. Nephrol Dial Transplant 7: 158–160

    Google Scholar 

  7. Morgan ER, Smalley LA (1983) Varicella in immunocompromised children. Incidence of abdominal pain and organ involvement. Am J Dis Child 137: 883–885

    Google Scholar 

  8. Bradley JR, Wreghitt TG, Evans DB (1987) Chickenpox in adult renal transplant recipients. Nephrol Dial Transplant 1: 242–245

    Google Scholar 

  9. Lynfield R, Herrin JT, Rubin RH (1992) Varicella in pediatric renal transplant recipients. Pediatrics 90: 216–220

    Google Scholar 

  10. Schröter GPJ (1992) Fatal varicella with liver necrosis after kidney transplantation. Clin Transplant 6: 388–390

    Google Scholar 

  11. Takahashi M, Otsuka T, Okuno Y, Asano Y, Yazaki T, Isomura S (1974) Live attenuated varicella vaccine used to prevent the spread of varicella in hospital. Lancet II: 1288–1290

    Google Scholar 

  12. Arbetter AM, Starr SE, Plotkin SA (1986) Varicella vaccine studies in healthy children and adults. Pediatrics 78: 748–756

    Google Scholar 

  13. Weibel RE, Beverly JN, Kuter BJ, Guess HA, Rothenberger CA, Fitzgerald AJ, Connor KA, McLean AA, Hilleman MR, Buynak EB, Scolnick EM (1984) Live attenuated varicella virus vaccine. Efficacy trial in healthy children. N Engl J Med 310: 1409–1415

    Google Scholar 

  14. Gershon A, Steinberg G, Gelb L, NIAID Varicella Vaccine Collaborative Study Group (1986) Multicentre trial of live attenuated varicella vaccine in immunocompromised children and healthy adults. Pediatrics 78: 757–762

    Google Scholar 

  15. Gershon AA, Larussa P, Hardy I, Steinberg S, Silverstein S (1992) Varicella vaccine — the American experience. J Infect Dis 166: S63-S68

    Google Scholar 

  16. Broyer M, Boudailliez B (1985) Varicella vaccine in children with chronic renal insufficiency. Postgrad Med J 61 [Suppl 4]: 103–106

    Google Scholar 

  17. Shepp DH, Dandliker PS, Meyers JD (1986) Treatment of varicella-zoster virus infection in severely immunocompromised patients. A randomized comparison of acyclovir and vidarabine. N Engl J Med 314: 208–212

    Google Scholar 

  18. Tsolia M, Gershon AA, Steinberg SP, Gelb L, NIAID Varicella Vaccine Collaborative Study Group (1990) Live attenuated varicella vaccine: evidence that the virus is attenuated and the importance of skin lesions in transmission of varicella-zoster virus. J Pediatr 116: 184–189

    Google Scholar 

  19. White CJ, Kuter BJ, Hildebrand CS, Isganitis KL, Matthews H, Miller WJ, Provost PJ, Ellis RW, Gerety RJ, Calandra GB (1991) Varicella vaccine (VARIVAX) in healthy children and adolescents: results from clinical trials, 1987 to 1989. Pediatrics 87: 604–610

    Google Scholar 

  20. Arvin AM (1992) Cell-mediated immunity to varicella-zoster virus. J Infect Dis 166: S35-S41

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zamora, I., Simon, J.M., Da Silva, M.E. et al. Attenuated varicella virus vaccine in children with renal transplants. Pediatr Nephrol 8, 190–192 (1994). https://doi.org/10.1007/BF00865476

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00865476

Key words

Navigation