40% of Liver Transplant Recipients Remain Unvaccinated Against Hepatitis B, Raising Risk of Severe Complications: Study
A study published in Clinical Infectious Diseases found that only 60% of liver transplant recipients were vaccinated against hepatitis B virus (HBV), leaving 4 in 10 unprotected against potentially severe complications. Researchers from Baylor College of Medicine analyzed data from deceased-donor liver transplant recipients between September 2022 and June 2024 using the United Network for Organ Sharing (UNOS) database. Factors associated with lower vaccine uptake included older age, alcohol-associated liver disease, shorter waiting-list duration, and lower educational attainment. The findings highlight gaps in HBV vaccination coverage among liver transplant recipients and the need to improve pre-transplant vaccination practices.
The study was conducted by Michael A. and colleagues. To estimate the viral hepatitis vaccination coverage rates at the national level and the clinicodemographic characteristics associated with lack of vaccination, scientists from the Baylor College of Medicine carried out a retrospective cohort study based on the analysis of national registry data.
Researchers obtained data from the United Network for Organ Sharing (UNOS) registry that included all adults who received liver transplantation from a deceased donor within September 1, 2022, and June 30, 2024. The research team studied immunization history, region, cause of liver disease, waitlist time, age, and socioeconomic status of patients.
Key findings:
- Results from the data analysis from the United Network for Organ Sharing database for the period of 22 months showed large gaps in vaccination, along with clear demographic differences.
- Less than 59.9% of patients who had received liver transplants using deceased donor organs from September 1, 2022, to June 30, 2024, had been fully immunized for the hepatitis B virus.
- This means that about 40% of patients were not vaccinated prior to transplantation. Immunity levels varied geographically throughout transplant regions of the country.
- Vaccination levels were independently linked to advanced age and low educational level of the patients.
- The presence of alcohol-related liver disease and short waiting list times were also independent predictors of vaccination.
In summary, empirical data from the UNOS registry highlight important gaps in pre-transplant preventive care in terms of lack of protection against hepatitis B virus among 40 percent of patients receiving livers. The findings of the study clearly indicate the importance of implementing multilevel interventions along with new vaccines to ensure the immunization of high-risk populations.
Reference:
Michael A Shi, Jeong Han, Ramsey Albahra, Maria F Machicao, Chia-Yu Chiu, Saira Khaderi, Ruben Hernaez, Fasiha Kanwal, Hashem B El-Serag, George Cholankeril, Tzu-Hao Lee, Hepatitis B Vaccination for Liver Transplant Recipients in the United States: A National Cohort Study, Clinical Infectious Diseases, 2026;, ciag585, https://doi.org/10.1093/cid/ciag585
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