The risk of invasive pneumococcal disease (IPD) among kidney transplant recipients is about 9 times higher than in the general population. IPD in solid-organ transplant recipients has a mortality rate of about 30. Pneumococcal vaccine is significantly effective to prevent IPD and is currently recommended for solid-organ transplant recipients. We vaccinated all blood-group-incompatible living-donor kidney transplant recipients who needed a splenectomy with 23-valent pneumococcal polysaccharide vaccine (PPV23) in 2006. Since 2007, we have vaccinated all living-donor kidney transplant recipients before transplantation. Two cases of IPD occurred in our department from January 1, 2000, to May 31, 2014. Case 1, who was not vaccinated, died the next day after the onset of IPD in spite of intensive care, and the pneumococcal serotype was type 18C. Case 2, who was vaccinated only once, eventually involved severe neurological sequelae and the pneumococcal serotype was type 24. PPV23 contains 85.4 pneumococcal serotypes responsible for IPD in Japan. It contains type 18C but not type 24. We consider pneumococcal vaccination to be extremely important to all kidney transplant recipients.
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