This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Influenza remains a significant cause of morbidity and mortality worldwide. The majority of complications and deaths from influenza occur in high-risk populations including those at the extremes of age, with chronic medical illnesses and immunosuppressive conditions. With the success of solid organ transplantation and other immunosuppressive therapies, the immunosuppressed population is rapidly increasing. The trivalent subviron influenza vaccine is efficacious in immunocompetent children and adults. However, it is much less immunogenic in pediatric solid liver transplant recipients and there are no studies evaluating the efficacy and cell-mediated immune response of the influenza vaccine in pediatric liver transplant recipients. To that end, we propose a prospective comparative study of the cell-mediated and humoral immune responses to the trivalent subviron influenza vaccine in 44 pediatric liver transplant recipients and 22 health controls. Additionally, we will try to establish the level of immune function predictive of an immune response. Understanding the immune responses in this population to this influenza vaccine will contribute to our understanding of the cell-mediated and humoral immune responses in this immunocompromised population and may lead to other vaccines and vaccine strategies aimed at preventing disease from influenza and other agents, including agents of bioterrorism in high risk populations. Our hypothesis is that liver transplant recipients will develop influenza specific humoral and cell-mediated immune responses following routine influenza vaccination.
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