Kidney transplant recipients vaccinated before transplantation maintain superior humoral response to SARS-CoV-2 vaccine.
Ayelet GrupperEugene KatchmanMerav Ben-YehoyadaLiane RabinowichDoron SchwartzIdit F SchwartzMoshe ShasharTami HalperinDan TurnerYaacov GoykhmanOren ShiboletSharon LevyInbal HouriRoni BaruchHelena KatchmanPublished in: Clinical transplantation (2021)
Majority of transplant recipients did not develop an appreciable humoral response following SARS-CoV-2 vaccine, in contrast to dialysis patients and healthy individuals. We analyzed the serologic response to BNT162b2 (Pfizer-BioNTech) vaccine in a cohort of 19 kidney transplant recipients, vaccinated prior to transplantation, compare to 109 recipients vaccinated after transplantation, and to 39 healthcare workers, by determining the level of anti-spike antibodies after transplantation. All controls and 17 of 19 (90%) of recipients vaccinated before transplant were seropositive, while only 49 of 109 (45%) recipients vaccinated post-transplant had positive serology (P < .001). Median anti-spike IgG in the group of kidney transplant recipients vaccinated after transplantation (10.7 AU/ml, [IQR 0-62.5]) was lower than the patients vaccinated before transplantation (66.2 AU/ml [21.6-138]), which was significantly lower than in the controls (156 AU/ml [99.7-215.5]). Negative humoral response was associated with vaccination post transplantation (odds ratio 22.4), older age (OR = 1.04), and longer time on dialysis (OR = 1.02), while higher lymphocyte count at time of vaccination was protective (OR = .52). Our findings of sustained superior humoral response to SARS-CoV-2 vaccine in kidney transplant recipients vaccinated prior to transplantation strongly support the recommendations of SARS-CoV-2 vaccination of transplant candidates, especially those younger than 60 years.
Keyphrases
- sars cov
- end stage renal disease
- immune response
- chronic kidney disease
- respiratory syndrome coronavirus
- cell therapy
- peritoneal dialysis
- ejection fraction
- newly diagnosed
- stem cells
- peripheral blood
- magnetic resonance imaging
- magnetic resonance
- physical activity
- mesenchymal stem cells
- computed tomography
- kidney transplantation
- middle aged
- community dwelling