American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended protocol for hepatitis B immunization prior to solid organ transplantation?

1. Complete series if already immune

2. Complete series if not already immune

3. Single dose of vaccine regardless of immune status

4. No vaccination required before transplantation

The correct answer is: Complete series if not already immune

The recommended protocol for hepatitis B immunization prior to solid organ transplantation emphasizes ensuring that potential transplant recipients have adequate immunity to hepatitis B, particularly if they do not already exhibit immune status. In patients who are not immune to hepatitis B, the complete series of vaccinations is vital to build up protective immunity against the virus. This is crucial because solid organ transplant recipients are at increased risk for infections due to immunosuppressive therapy that will follow the transplant. Therefore, ensuring they have adequate immunity through vaccination prior to the procedure is a key preventative measure. This approach solidifies the patient's preparedness and enhances their safety post-transplant. The vaccination series confers a stronger protective effect than a single dose, which would not provide sufficient immunity. Evaluating and addressing a patient’s hepatitis B immunity status before organ transplantation not only complies with standard medical recommendations but also optimizes outcomes for patients undergoing such significant procedures.