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Let me pitch hit for Dr. Aubrey since I looked at vaccines before my

recent transplant.

It is important to be up to date on the usual vaccines (the transplant

programs should collect this information on you and bring you up to

date):

Influenza

Hep A

Hep B

Tetnus/Diptheria/Pertussis

Measles/mumps/rebella (depending on age)

Pneumonia

Papaloma virus (for young women)

Meningitis (for those in college or military that might live in a

dormatory, or if spleenectomy considered)

H. flu (important if spleenectomy)

see: http://www.cdc.gov/nip/diseases/adult-vpd.htm#schedule

There is a new varicella vacine for adults that prevents shingles. It

hasn't been tested pre-transplant or immune deficient but it makes

sense to me and I had it for about $200. My transplant program didn't

have it on the list and didn't have an opinion on it yet because it is

so new. If you choose to get it make sure you get the adult dose and

when your insurance denys it because you are less than 65 years

old,request an exception.

There is no good herpes vaccine yet.

" Kline Beecham recently released the results of their study

regarding a new vaccine attempt for genital herpes. Sadly, the results

indicate that any benefit from the vaccine seems to be limited to

female patients who have never had a type 1 herpes simplex infection

AND who do not have genital herpes currently. This seems to mean that

the vaccine only offers partial protection from acquiring type 2

genital herpes. "

The anticancer vaccines are experimental and not used for prevention.

I've never heard of one for lymphoma but there is one for melanoma

which if ever developed for prevention would be a good idea.

Good luck

Von

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Let me pitch hit for Dr. Aubrey since I looked at vaccines before my

recent transplant.

It is important to be up to date on the usual vaccines (the transplant

programs should collect this information on you and bring you up to

date):

Influenza

Hep A

Hep B

Tetnus/Diptheria/Pertussis

Measles/mumps/rebella (depending on age)

Pneumonia

Papaloma virus (for young women)

Meningitis (for those in college or military that might live in a

dormatory, or if spleenectomy considered)

H. flu (important if spleenectomy)

see: http://www.cdc.gov/nip/diseases/adult-vpd.htm#schedule

There is a new varicella vacine for adults that prevents shingles. It

hasn't been tested pre-transplant or immune deficient but it makes

sense to me and I had it for about $200. My transplant program didn't

have it on the list and didn't have an opinion on it yet because it is

so new. If you choose to get it make sure you get the adult dose and

when your insurance denys it because you are less than 65 years

old,request an exception.

There is no good herpes vaccine yet.

" Kline Beecham recently released the results of their study

regarding a new vaccine attempt for genital herpes. Sadly, the results

indicate that any benefit from the vaccine seems to be limited to

female patients who have never had a type 1 herpes simplex infection

AND who do not have genital herpes currently. This seems to mean that

the vaccine only offers partial protection from acquiring type 2

genital herpes. "

The anticancer vaccines are experimental and not used for prevention.

I've never heard of one for lymphoma but there is one for melanoma

which if ever developed for prevention would be a good idea.

Good luck

Von

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Let me pitch hit for Dr. Aubrey since I looked at vaccines before my

recent transplant.

It is important to be up to date on the usual vaccines (the transplant

programs should collect this information on you and bring you up to

date):

Influenza

Hep A

Hep B

Tetnus/Diptheria/Pertussis

Measles/mumps/rebella (depending on age)

Pneumonia

Papaloma virus (for young women)

Meningitis (for those in college or military that might live in a

dormatory, or if spleenectomy considered)

H. flu (important if spleenectomy)

see: http://www.cdc.gov/nip/diseases/adult-vpd.htm#schedule

There is a new varicella vacine for adults that prevents shingles. It

hasn't been tested pre-transplant or immune deficient but it makes

sense to me and I had it for about $200. My transplant program didn't

have it on the list and didn't have an opinion on it yet because it is

so new. If you choose to get it make sure you get the adult dose and

when your insurance denys it because you are less than 65 years

old,request an exception.

There is no good herpes vaccine yet.

" Kline Beecham recently released the results of their study

regarding a new vaccine attempt for genital herpes. Sadly, the results

indicate that any benefit from the vaccine seems to be limited to

female patients who have never had a type 1 herpes simplex infection

AND who do not have genital herpes currently. This seems to mean that

the vaccine only offers partial protection from acquiring type 2

genital herpes. "

The anticancer vaccines are experimental and not used for prevention.

I've never heard of one for lymphoma but there is one for melanoma

which if ever developed for prevention would be a good idea.

Good luck

Von

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Hi Barb,

I'll pitch hit for Dr. Aubrey since he hasn't logged on for a few

days. He told me that he takes a break from the list from time to time

because he has been at it so long. My practice is General Internal

Medicine since 1989. Doctors don't always agree on everything about

PSC because precious little is known for sure so some times we

extrapolate from similar things or have had different experience.

Anyway there are no dumb questions.

Here is the CDC chart for adult immunizations (it hasn't been updated

for the new adult varicella vaccine)

http://www.cdc.gov/nip/recs/adult-schedule.pdf

Everyone in the general public should have the childhood MMR if they

missed it as kids

The meningitis indications are listed. Since it is so rare it is not

recommended to the general public but just to those that might live in

dormitories (military, students) or lab workers or locations that have

had outbreaks etc.

Most people having a transplant do not have the spleen removed so

wouldn't need the meningitis or Hib.

Why is his team recommending spleenectomy ? Ask your team to explain

the reasoning for it so that it makes sense to you. I don't want to

step on any toes but it may not be a good idea in a standard

transplant. There are Japanese teams that when doing living donor Tx,

tie off part of the blood supply to the spleen if it is more than 50%

of the liver size to reduce portal hypertension and not give a small

graft too much blood. To actually take the spleen out requires more

operating time and higher risk of bleeding and infection.

The Herpes Simplex (cold sores and genital ulcers) vaccines just

haven't been effective. The Herpes ZOSTER vaccine is the varicella

vaccine.

Acylovir can be used for prophalaxis or treatment of Herpes Simplex.

My team in Denver didn't want to treat cold sores right after

transplant because they usually clear anyway and they didn't want any

side effects during that crucial phase.

CMV is treated with antivirals if patients have no antibodies from

previous infection (this is a pre-transplant blood test) and the donor

was exposed.

Ken is lucky to have such an involved, and proactive and inquiring mom!

Von

>

> Most probably stupid questions..but still want to know answer.

>

> *IF* these vaccinations are suppose to protect Ken against bacterial

> infections, (after they remove his spleen) why don't they give them to

> everyone undergoing a transplant?

>

> Why not give them to the general public like the childhood ones?

>

> Barb in Texas - Together in the Fight, Whatever it Takes!

> Son Ken (32) UC 91 - PSC 99

>

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  • 4 months later...
Guest guest

-----Original

Message-----

Stay calm, be brave, and wait for the results.

Thank you very much

Aubrey. Don’t know what I

would do without your advice and willingness to share your expertise. Actually, right now, I’m not worried;

we have had so many mistaken diagnoses (some really nasty) over the years, that

I’ve learned to wait and see proof for myself.

But…..the coordinator

didn’t mention the findings, not sure she ever would have (or if she even

read the report). Now, armed with your opinion, I

know if they don’t make a quick move to investigate it further, I’ll

have to “help” them along ;-)

Ken is still #1 in the AB group at Baylor, but I sure don’t want

him to get the call before they find out what the

nodule is.

Thank you so much Dr

Aubrey,

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

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Guest guest

Barb,

Sorry to hear about this. I hope it isn't anything serious, but of course

the thought of it being serious can't be helped. I'll be thinking about you

and your family, and hoping this isn't serious.

-Marie

P.S. The results of my CT scan from last week are in - everything was okay.

But I'm not sure if this is the best test for CCA.

>

>Ken had an ultra sound done on Wednesday. We just got the results back

>and they saw a " 2.5 nodule near the gallbladder fossa " , this is

>something new and wasn't there 6 months ago. Radiology recommends an

>MRI and correlation with AFP (his last AFP was done on 1/15, and was 2.7

>- normal). His Hepatologist is out of town until Tuesday (naturally),

>but his coordinator thinks he will want to order the MRI & AFP.

>

>My question - could something nasty have popped up in just 6 months

>time?

>

>Barb in Texas - Together in the Fight, Whatever it Takes!

>Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

>

>

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