Liver transplantation (LT) recipients are susceptible to infections, including measles. Concerns about the safety and efficacy of live-attenuated vaccines, such as the measles-mumps-rubella (MMR) vaccine, have led to hesitancy among providers in administering them to immunocompromised patients. This 9-year interventional study assessed seroprotection against measles following MMR vaccination in pediatric LT recipients. Of 119 participants enrolled, 60 (50%) were seroprotected against measles after transplantation. Among the 59 nonseroprotected participants, 56 fulfilled safety criteria and received MMR vaccination with a seroprotection rate of 90% (95% confidence interval [CI], 73%-98%) after a first dose, 95% (95% CI, 85%-99%) after primary vaccination with 1 to 3 doses, comparable to nonimmunocompromized populations. However, measles antibodies declined over time, suggesting the need for regular monitoring, and booster doses. Half of the vaccinees (26/53, 49%) subsequently lost seroprotection. Among them, 23 received additional doses of MMR, with a high seroconversion rate. At their last follow-up (median, 6.1 years; interquartile range, 3.0-8.1 after inclusion), 63% (95% CI, 49%-75%) of all vaccinees were seroprotected against measles. In conclusion, MMR vaccination in pediatric LT recipients offers seroprotection against measles, but long-term immunity should be monitored closely.

中文翻译：

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小儿肝移植前后接种麻疹-腮腺炎-风疹疫苗后对麻疹的血清保护作用长期持续存在


肝移植 （LT） 受者易受感染，包括麻疹。对麻疹-腮腺炎-风疹 （MMR） 疫苗等减毒活疫苗的安全性和有效性的担忧导致提供者在为免疫功能低下的患者接种减毒活疫苗时犹豫不决。这项为期 9 年的干预研究评估了儿科 LT 接受者接种 MMR 疫苗后对麻疹的血清保护作用。在入组的 119 名参与者中，60 名 （50%） 在移植后接受了麻疹血清保护。在 59 名非血清保护参与者中，56 名符合安全标准并接受了 MMR 疫苗接种，第一剂后血清保护率为 90% （95% 置信区间 [CI]，73%-98%），初次接种 1 至 3 剂后为 95% （95% CI，85%-99%），与非免疫功能低下人群相当。然而，麻疹抗体随着时间的推移而下降，这表明需要定期监测和加强剂量。一半的疫苗接种者 （26/53， 49%） 随后失去了血清保护。其中，23 例接受了额外剂量的 MMR，血清转化率高。在最后一次随访时 （中位数，6.1 年;四分位距，纳入后 3.0-8.1），63% （95% CI，49%-75%） 的疫苗接种者受到麻疹血清保护。总之，儿科 LT 接受者的 MMR 疫苗接种提供了针对麻疹的血清保护，但应密切监测长期免疫力。