SickKids’ TRMC takes the lead in developing global post-transplant live vaccine consensus protocol

By: Shehnaz Jaffar

The Transplant & Regenerative Medicine Centre (TRMC) at SickKids is leading a global effort to develop clinical guidelines around the use of live vaccines in patients who have received solid organ transplants.

The TRMC led a Live Vaccine Consortium in February to develop a consensus protocol on the administration of live vaccines post-transplant. This innovative consortium brought together 17 experts in the fields of infectious diseases, immunology and solid organ transplant from across North America and Europe. More than 50 participants attended the plenary sessions held at the PGCRL and more than 40 participated via webinar.

Traditionally, administering live vaccines, such as the chicken pox vaccine, is widely considered inadvisable right after a solid organ transplant. In theory, transplant patients, whose immunity has been compromised, are at risk of getting vaccine-associated disease. Nevertheless, live vaccines can help to prevent life-threatening diseases, such as varicella, after organ transplantation. It is still unclear, though, which sub-groups of patients can and cannot be safely vaccinated.

One of the challenges is that an increasing number of number of health centres are starting to vaccinate patients in an unstructured manner. In many other situations involving organ transplantation, clinicians are often guided by home-grown protocols. Though this issue has been discussed at various global sold organ transplant conferences, no institution has taken the lead to develop a protocol in collaboration with world leaders in the field.

“The TRMC Live Vaccine Consortium will lead to a document that will guide the use of live vaccines after organ transplantation, to be used by transplant centres around the world. This will be the first international consensus protocol on this issue,” says Dr. Upton Allen, Chief, Division of Infectious Diseases. “Along with the international experts involved, SickKids will be viewed as a leader on this topic and be consulted or looked to for guidance on solid organ transplant immunizations.”

Currently, the consortium is developing a manuscript, with plans to publish it before the end of 2018. The document will set the stage for future international collaborations on research relating to this issue.