Influenza vaccination in orthotopic liver transplant recipients: absence of post administration ALT elevation

Am J Transplant. 2004 Nov;4(11):1805-9. doi: 10.1111/j.1600-6143.2004.00564.x.


Influenza vaccination has reduced life-threatening complications from influenza virus infection in adult liver transplant recipients. We evaluated changes in aminotransferase level and immunogenicity of influenza vaccination in liver transplant recipients. Fifty-one liver transplant recipients were administered a standard dose of the 2002-2003 inactivated trivalent influenza vaccine. ALT values were measured at baseline, 1 week and 4-6 weeks postvaccination. Antibody responses to each component of the vaccine were measured at baseline and after 4-6 weeks by a hemagglutination inhibition (HAI) assay. Response was defined as an HAI titer > or = 1: 40 and/or a 4-fold increase in antibody titers from baseline. An ALT elevation was defined as a rise of > or = 50% from baseline. There was no difference in the median rise in ALT value between seroconverters and nonseroconverters. A significant number of recipients developed potentially protective antibody titers (p-value < 0.0001). At less than 4 months post transplantation, 1/7 (14%), at 4-12 months, 6/9 (67%), and after 12 months, 30/35 (86%) subjects responded to the H1 strain. Of 51 recipients, one HCV (-) recipients vaccinated within 3 months of transplantation developed acute cellular rejection. Influenza virus vaccination is not associated with allograft rejection or ALT flares in liver transplant recipients.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood*
  • Albuminuria
  • Alkaline Phosphatase / blood
  • Drug Therapy, Combination
  • Female
  • Fever / etiology
  • Hemagglutination Inhibition Tests
  • Hepatitis C / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Influenza Vaccines* / adverse effects
  • Liver Function Tests
  • Liver Transplantation / immunology
  • Liver Transplantation / physiology*
  • Male
  • Middle Aged
  • Serum Albumin / analysis


  • Immunosuppressive Agents
  • Influenza Vaccines
  • Serum Albumin
  • Alanine Transaminase
  • Alkaline Phosphatase