Clinical Efficacy of Pretransplant Vaccination for Preventing Herpes Zoster After Living Donor Liver Transplantation in Recipients Age 50 Years and Older

BACKGROUND There have been no reports concerning the efficacy of pretransplant herpes zoster (HZ) vaccination following living donor liver transplantation (LDLT). MATERIAL AND METHODS From January 2013 to May 2016, 24 patients age 50 years and older received vaccination of HZ prior to transplantation and underwent LDLT at a single institution. We compared this to the 1-year HZ incidence of unvaccinated recipients (N=180) who underwent LDLT in the same time period. RESULTS For general characteristics, the MELD scores (p<0.001) and CTP grades (p=0.007) of the vaccinated group were significantly lower than those of the unvaccinated group. In Kaplan-Meier analysis, the 1-year HZ incidence rates of the vaccinated and unvaccinated groups were 2 (8.7%) and 16 (9.9%) cases, respectively (p=0.883). In the subgroup aged 50-59 years, 2 vaccinated recipients had HZ after LDLT. However, in the subgroup aged 60 years and older, no vaccinated recipients had HZ after LDLT. Multivariate analysis showed the independent risk factor for HZ after LDLT was use of mycophenolate mofetil (MMF; hazard ratio [HR]=3.00; p=0.041). CONCLUSIONS The efficacy of pretransplant vaccination for preventing HZ was not apparent in our study. A large prospective study is needed to determine the indications for pretransplant HZ vaccination according to age group and to evaluate the efficacy of HZ vaccination after LDLT.