Renal Transplantation Protocol: Immunisations
|A. Killed Vaccines||Pre-Transplant||Post-Transplant|
|Tetanus / diphtheria / inactive polio1||Yes|
|Typhoid (inactive polysaccharide vaccine)||Yes||Yes|
|Pneumococcal / Meningococcal / Hib||Yes|
|Combined Hepatitis A / B (TWINRIX)||Yes||Yes|
|B. Live Vaccines||Pre-Transplant||Post-Transplant|
|Yellow Fever Vaccine||Yes||Contraindicated|
- There is no risk of infection from vaccines and susceptible contacts.
- Measles – patients who are immunosuppressed and come into contact with measles should receive HNIG (human normal immunoglobulin) as soon as possible, but within 6 days.
- Chickenpox – Varicella zoster immunoglobulin (VZIG) is indicated in patients who have had significant exposure to chickenpox or shingles and who have no antibodies to VZ. VZIG should be given within 7 days of contact.
- Yellow Fever â€“ patients post-transplant intending to travel to countries where a Yellow Fever vaccination certificate is mandatory should obtain a letter of exemption from a medical practitioner. (Yellow Fever occurs in tropical Africa and in South America â€“ see WHO website for details.)
Malaria Prophylaxis â€“ up-to-date information on Malaria prophylaxis for a given destination is available from pharmacy. The following table gives an indication of interactions:
|Choloroquine||tacrolimus (CP450 3A4)||CyA (CP450 3A4)|
|Proguanil||No interactions likely||No interaction |
|Mefloquine||tacrolimus (displacement from plasma |
|No interaction |
|Doxycycline||tacrolimus (CP450 3A4)||CyA (CP450 3A4)|