Günther M, Stark K, Neuhaus R, Reinke P, Schröder K, Bienzle U (2001): Rapid decline of antibodies after hepatitis A immunisation in liver and renal transplant recipients
Transplantation 71: 477-479.

Background. Hepatitis A vaccine is safe and achieves good seroconversion rates in liver (LTX) and renal (RTX) transplant recipients. Methods. A study was performed to determine the anti-hepatitis A virus (HAV) anti-body decline in LTX and RTX patients, and in healthy controls who have been immunised with two doses of hepatitis A vaccine. Results. LTX and RTX patients had a satisfactory seroconversion rate after complete immunisation. However, two years later they had experienced a much more rapid antibody decline than controls, and only 59% of LTX and 26% of RTX seroconverters showed titres above the cut-off level defined as protective. Conclusions. Patients on immunosuppressive therapy may not be adequately protected against hepatitis A a few years after vaccination.