Induction of Immunity Against Measles in Pediatric Liver Transplant Recipients (MMRinOLT)

Klara M. Pósfay Barbe

Status and phase

Enrolling

Phase 4

Conditions

Measles

Treatments

Biological: MMR vaccination

Study type

Interventional

Funder types

Other

Identifiers

NCT01770119

12-226 (MatPed 12-048) (Other Identifier)

MMR in pediatric OLT

Details and patient eligibility

About

Measles is a vaccine-preventable disease, which can be life-threatening in immunosuppressed children. Currently, measles vaccine is not recommended in pediatric orthotopic liver transplant recipients, because it is a live-attenuated vaccine.

We want to assess the influence of immunosuppression on immunity against measles in previously vaccinated children and to evaluate the induction of B cell and T cell response against measles elicited by vaccination in children at least 12 months after transplantation.

Full description

Eligible children in Group 2 will receive a standard dose (0.5 ml) of MMR vaccine during the first medical visit (V1). The lot number and the expiration date will both be recorded on the patient's case report form (CRF). A serological evaluation 4-8 weeks after MMR will identify children requiring an additional dose given 1-2 months apart, as currently recommended for subjects 1 year-old or with limited immune competence (i.e. HIV-infected children). Serological evaluation 4-8 weeks after the second dose or at the one-year follow-up will identify eventual non-responder requiring a third dose. Three will be the maximal number of administrated dose according to this protocol. The persistence of measles-specific antibodies will be assessed yearly, when patients come for their routine visit to the transplant center.

Children who do not need MMR immunization because of protective levels will be monitored yearly for maintenance of antibody levels during routine yearly visits/ blood samplings and will not have further intervention.

Enrollment

90 estimated patients

Sex

All

Ages

12 months to 20 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥ 12 months
Measles-specific IgG antibodies negative (<0.2 IU/L), as detected by the routine ELISA assay
≥ 12 months from the time of transplantation and ≥ 2 months from the time of an acute rejection episode
Steroids < 2 mg/kg/day, tacrolimus < 0.3mg/kg/day and tacrolimus level < 8 ng/ml for > 1 month.
Total lymphocyte count ≥ 750 cells/ul at time of immunization

Exclusion criteria

Known wild-type measles exposure during the last four weeks
Measles-containing immunoglobulins administered within the 5 months preceding the measles vaccine. If the child receives measles-containing Ig before an additional dose of MMR vaccine, he/she will be withdrawn from the study
Antiviral agents administered during the last four weeks
Febrile illness (>38.5°) in the 72 hours before vaccine administration
Chronic aspirin therapy
Any other immunization with a live-attenuated vaccine during the last four weeks
Pregnancy