Immunizations in adult liver transplant candidates and recipients

Liver transplant (LT) recipients are at high risk of infections due to both immune dysfunctions associated with liver disease and immunosuppressive therapy necessary after transplantation.Effective vaccination strategies are crucial to prevent vaccine-preventable diseases, which remain a significant cause of morbidity and mortality in this population.Vaccines should be administered as early in the pre-transplant period as possible when the likelihood of developing a protective immune response is highest and when live vaccines can be given safely.Live vaccines should be given at least 4 weeks prior to transplantation in immunocompetent patients.With rare exception, live vaccines are contraindicated in LT recipients.Post-transplantation, inactivated vaccines are generally safe, although their efficacy may be diminished.This review provides a detailed overview of current vaccination guidelines for adult LT candidates and recipients, covering key vaccines including influenza, pneumococcus, hepatitis A and B, herpes zoster, and tetanus-diphtheria.