Hepatitis A vaccination during ventricular assist device support in heart transplant candidates: immunogenicity and safety in a single-center cohort

Vaccination is among the cornerstones of infectious disease prevention in heart transplant candidates and recipients. Guidelines recommend an inactivated hepatitis A virus vaccine for heart transplant candidates, many of whom are on ventricular assist devices and at risk of hepatitis A virus exposure. However, data on the immunogenicity and safety of hepatitis A virus vaccines in these patients are lacking.This retrospective, observational, single-center study was conducted at our outpatient clinic between December 2019 and December 2025. The study participants were heart transplant candidates with ventricular assist devices aged ≥16 years who tested negative for anti-hepatitis A virus immunoglobulin G at baseline and completed the inactivated hepatitis A virus vaccination series. Anti-hepatitis A virus immunoglobulin G titers were measured after vaccination using a chemiluminescent immunoassay. Thirty-five individuals were included in the study. Immunosuppressive agents were used in four patients (11.4%). All participants achieved seroconversion at a median of 1 month after vaccination. The reverse cumulative distribution of the Anti-hepatitis A virus immunoglobulin G sample/cutoff values indicated that an adequate antibody response was achieved in individuals with ventricular assist devices. Adverse events of the vaccine were minor; two patients (6%) experienced local pain, and two (6%) subcutaneous hemorrhage. Seroconversion in patients with ventricular assist devices was high. hepatitis A virus vaccination should be completed before transplantation in heart transplant candidates, if indicated.