Author information

¹Department of Pediatrics, Division of Pediatric Infectious Diseases, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California, USA.

²Department of Pediatrics and Internal Medicine, University of Rochester, Rochester, New York, USA.

³Department of Obstetrics and Gynecology, Santa Clara Homestead Medical Center, Kaiser Permanente, Santa Clara, USA.

⁴Division of Pediatric Gastroenterology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California, USA.

⁵Department of Pediatrics, Division of Pediatric Gastroenterology, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California, USA.

⁶Pediatric Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Abstract

Background: Pediatric liver transplant recipients are at increased risk of post-transplant infections. The purpose of this study was to quantify hepatitis A and B non-immunity based on antibody titers in liver transplant recipients.

Methods: We conducted a retrospective chart review of 107 pediatric liver transplant recipients at a single medical center from 2000 to 2017. We compared hepatitis immune patients to non-immune patients and studied response to vaccination in patients immunized post-transplantation.

Results: Eighty-one percent of patients had pre-transplant immunity to hepatitis A whereas 68% had pre-transplant immunity to hepatitis B. Post-transplant hepatitis B immunity decreased to 33% whereas post-transplant hepatitis A immunity remained high at 82%. Older age and time since transplantation were significantly associated with hepatitis B non-immunity. Most patients responded to doses post-transplantation with 78% seroconversion following hepatitis A re-immunization and 83% seroconversion following hepatitis B re-immunization.

Conclusions: Pediatric liver transplant recipients are at risk of hepatitis A and B non-immunity, particularly with respect to hepatitis B. Boosters post-transplant may improve immunity to hepatitis viruses.