Impfungen bei nierenkranken Kindern

Zusammenfassung

Nierenkranke Kinder profitieren von einer zeitgerechten Grundimmunisierung entsprechend den STIKO-Empfehlungen. Oberstes Ziel ist eine vollständige Grundimmunisierung vor Transplantation. Neben der Grundimmunisierung sind Indikationsimpfungen wie Pneumokokken, Influenza sinnvoll. Da die Impfantwort gegenüber einzelnen Impfstoffen (z. B. Hepatitis B, Varicella) reduziert sein kann, sind Antikörperbestimmungen und Boosterimpfungen häufiger erforderlich. Sie dienen zur Beurteilung des Impferfolges sowie der Schutzdauer. Im ersten Jahr nach einer Organtransplantation sind Impfungen aufgrund der verstärkten Immunsuppression meist nicht erfolgreich. Bei Lebendimpfungen ist Zurückhaltung angebracht, im Einzelfall muss jedoch bei der Varizellenimpfung das Risiko der Infektion gegen das Impfrisiko abgewogen werden.

Summary

Immunization according to the STIKO guidelines is crucial for children with renal diseases. Physicians should aim to a complete immunization before transplantation. Additionally, influenza virus and pneumococcal vaccinations are recommended for children with nephrotic syndrome, renal insufficiency and after kidney transplantation. Determination of antibody concentrations and booster immunizations are required more frequently to assess immune response, the latter tends to be reduced in certain vaccines like hepatitis B or varicella zoster virus. The efficacy of immunizations is questionable during the first year after kidney tranplantation due to the immunosuppressive therapy. Although live vaccines are predominantly contraindicated in renal transplant recipients, individual cases with increased exposure may benefit from varicella zoster virus vaccination.

Schlüsselwörter

Niereninsuffizienz - Organtransplantation - Nierentransplantation - Impfungen - Immunisierung

Keywords

Renal insufficiency - solid organ transplantation - kidney transplantation - vaccination - immunization

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