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VZV IgG was assessed annually and compared with the induction agent used, the number of VZV vaccines received, and the interval between the last dose of VZV vaccine and Tx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median age at Tx was 16.7\u00a0years (IQR 12.7\u201318.5). 11 of 45 (24.4%) patients lost immunity to VZV at a median of 12.6\u00a0months post-Tx. Those who lost VZV immunity were younger at the time of Tx, 12.4\u00a0years vs. 17.3\u00a0years (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05) and more likely to be on steroid-based immunosuppression 81.8% vs. 32.4% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006). There were no differences between the induction agents used and the ability to maintain VZV IgG antibodies. Subjects who required\u2009\u22653 doses of VZV vaccine to develop VZV IgG seropositivity were at a higher risk for losing their anti-varicella antibody post-Tx (HR 3.81, 95% CI 1.09\u201313.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04). Receiving VZV vaccination\u2009&lt;1\u00a0year prior to kidney Tx was associated with a higher risk for losing anti-varicella antibody after Tx (HR 6.97, 95% CI 2.08\u201323.34).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this small cohort, pediatric kidney Tx recipients are more likely to lose VZV IgG in those who were younger at the time of Tx, on steroid-based immunosuppression, required 3 or more doses of VZV vaccination to seroconvert, or received VZV vaccine\u2009&lt;1\u00a0year before Tx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-025-07022-7","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T03:47:06Z","timestamp":1763005626000},"page":"837-844","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for loss of Varicella immunity after pediatric kidney transplantation"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-7483","authenticated-orcid":false,"given":"Helen","family":"Pizzo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya R.","family":"Soni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhosh","family":"Nadipuram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Mirocha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Garrison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherlyn","family":"Hilario","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dechu","family":"Puliyanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"7022_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1271065","volume":"11","author":"CM Kao","year":"2023","unstructured":"Kao CM, Michaels MG (2023) Approach to vaccinating the pediatric solid organ transplant candidate and recipient. 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