Immunity to Varicella, Measles, and Mumps in Patients Evaluated for Lung Transplantation.

Hostetler, Haley; Neely, Megan L; Lydon, Elizabeth; Danziger-Isakov, Lara A; Todd, Jamie L; Palmer, Scott M

Vaccine-preventable viral infections are associated with increased risk of morbidity and mortality in post-transplant patients on immunosuppression regimens. Therefore, we studied rates of immunity against vaccine-preventable viruses in lung transplantation (LTx) candidates and their associations with underlying lung disease and clinical characteristics. We retrospectively studied 1025 consecutive adult patients who underwent first-time evaluation for LTx at a single center between January 2016 and October 2018. Viruses studied included varicella zoster (VZV), measles, and mumps. Young age (17-48 yo) was negatively associated with immunity for VZV (OR 4.54, p<0.001), measles (OR 15.45, p <0.001) and mumps (OR 3.1, p <0.001), as compared to those 65+. Many LTx candidates with cystic fibrosis (CF) had undetectable virus-specific antibody titers including:13.5% for VZV, 19.1% for measles, and 15.7% for mumps with significant odds of undetectable titers for VZV (OR 4.54, p<0.001) and measles (OR 2.32, p=0.010) as compared to those without CF. Therefore, a substantial number of patients undergoing LTx evaluation had undetectable virus-specific antibody titers. Our results emphasize the importance of screening for immunity to vaccine-preventable infections in this population and the need for revaccination in selected patients to boost their humoral immunity prior to transplantation.