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Case Report
Fulminating varicella despite prophylactic immune globulin and intravenous acyclovir in a renal transplant recipient: should renal patients be vaccinated against VZV before transplantation?
Susan Robertson a , Karen Newbigging a , William Carman b , Gwyneth Jones a and Chris Isles a on behalf of the Scottish Renal Registry
  Renal Unit, Dumfries and Galloway Royal Infirmary, Dumfries and   West of Scotland Virology Centre, a member of the UK Clinical Virology Network, Gartnavel General Hospital, Glasgow, UK
Correspondence to Chris Isles, Renal Unit, Dumfries and Galloway Royal Infirmary, Dumfries, DG1 4AP, UK.
Tel.: 01387 241335; fax: 01387 241361;
e-mail: chris.isles@nhs.net
Copyright 2005 Blackwell Munksgaard
KEYWORDS
varicella zoster virus • chronic kidney disease • renal transplantation
Robertson S, Newbigging K, Carman W, Jones G, Isles C on behalf of the Scottish Renal Registry. Fulminating varicella despite prophylactic immune globulin and intravenous acyclovir in a renal transplant recipient: should renal patients be vaccinated against VZV before transplantation?
Clin Transplant 2005 DOI: 10.1111/j.1399-0012.2005.00435.x
© Blackwell Munksgaard, 2005

ABSTRACT

Abstract: We describe a case of fulminating varicella despite prophylactic immune globulin and intravenous acyclovir in a renal transplant recipient. This promoted a survey of all 383 adult patients awaiting a renal transplant in Scotland, which showed a low level of Varicella zoster virus (VZV) awareness but a willingness to consider vaccination if non immune. 359/363 serum samples tested were seropositive for VZV antibody giving a susceptibility to VZV of 1.2%. Although data on vaccination in adults with chronic kidney disease are limited, expert opinion is of the view that the benefits of vaccinating immunocompetent seronegative patients before transplantation are likely to outweigh the risks. We believe that adult patients awaiting a transplant in the UK should be tested for their susceptibility to VZV and that early vaccination should be offered to those who are both immunocompetent and seronegative.


Accepted for publication 13 July 2005

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1399-0012.2005.00435.x About DOI

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