American Board of Internal Medicine (ABIM) Certification Practice Exam

Before solid organ transplantation, how should human papillomavirus immunization comply?

1. Given only during the surgery

2. According to recommendations for nontransplant patients

3. No immunization is necessary

4. Should be given 6 months prior

The correct answer is: According to recommendations for nontransplant patients

The correct approach to human papillomavirus (HPV) immunization before solid organ transplantation aligns with the guidelines for nontransplant patients. This is because HPV vaccination is effectively preventive and provides immunity that can help mitigate the risks of HPV-related diseases, which are particularly concerning in immunocompromised individuals, such as those receiving organ transplants. Immunization should ideally be completed before the transplant procedure to ensure adequate response and to boost the immune system's ability to fight infections, which is crucial for the health of the patient post-transplant. Vaccination schedules typically recommend timely administration of vaccines for the best efficacy, suggesting that these should be administered according to the standards applied to individuals who are not undergoing transplantation. Moreover, given the immunosuppressive therapy that follows solid organ transplantation, it is beneficial to have such vaccinations completed beforehand to help provide a protected state from certain viruses and cancers that HPV can cause. In contrast, other options such as administering the vaccine only during surgery, stating that no immunization is necessary, or recommending vaccines specifically six months prior do not accurately reflect the optimal and recommended practices for HPV immunization for patients prior to undergoing solid organ transplantation. These practices could leave patients vulnerable to infections or other complications due to delayed vaccination.