Immunisation in renal transplantation –a joint audit

Abstract

<h3>Aim</h3> To review the vaccination practice of 2 paediatric nephrology units in Wales and South West England and to compare practice with the local guidelines and with national recommendations from RCPCH and Department of Health Immunisation is an effective strategy in improving host immunity prior to renal transplantation. Following transplantation, immunosuppressed patients are more susceptible to viral illness, including those transmitted through the transplanted organ and reactivation of latent infection. Screening for these viral illnesses pre and post transplantation is widespread clinical practice. <h3>Methods</h3> Data were collected retrospectively from the electronic records of the Cardiff and Bristol paediatric renal units and from primary care. 34 patients were audited between 2006 and 2010, 23 had been transplanted, 11 were waiting for transplantation. <h3>Results</h3> See tables 1, 2 and 3. <h3>Conclusions</h3> There is good uptake of primary courses of immunisations given as part of the national schedule and also indicated because of severe chronic kidney disease. However the delivery of booster doses is less effective and strategies for improvement are needed. Good viral antibody screening pre-transplant has been achieved but post transplant PCR monitoring is incomplete. The development of shared care pathways between primary care and the transplant team are needed to improve the delivery of immunisation to this vulnerable group of patients. Increasing awareness of the vaccination schedule amongst patients and families is a key step in improving uptake.