Immunization and Liver Transplantation

Vaccine-preventable illnesses are a source of considerable morbidity and mortality in liver transplant recipients. Nearly all liver transplant recipients require life-long immunosuppression, significantly increasing their risk of infections. The primary strategy for immunizing liver transplant recipients is to deliver all vaccines prior to liver transplantation. Liver transplant candidates are more likely to develop vaccine-induced immunity compared to transplant recipients receiving immunosuppression. Measles, mumps, and rubella vaccination is usually given in childhood, and together, although some individual vaccines are available. Induction immunosuppression in liver transplant recipients could result in ineffective vaccine response in the early post-transplant period. Hepatitis A vaccination should be offered to all patients with chronic liver disease. It is strongly recommended that members of the transplant care team be vaccinated against transmissible infections, such as measles, mumps, rubella, hepatitis B, and varicella zoster. All healthcare workers should also receive an annual influenza vaccine.