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Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients
BACKGROUND AND AIMS: After 2 doses, the efficacy of anti‐SARS‐CoV‐2 vaccination seems to be lower in solid organ transplant recipients than in the immunocompetent population. The objective of this study was to determine the humoral response rate after vaccination, including with a booster dose, and...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115190/ https://www.ncbi.nlm.nih.gov/pubmed/35338550 http://dx.doi.org/10.1111/liv.15258 |
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author | Meunier, Lucy Sanavio, Mathilde Dumortier, Jérôme Meszaros, Magdalena Faure, Stéphanie Ursic Bedoya, José Echenne, Maxime Boillot, Olivier Debourdeau, Antoine Pageaux, Georges Philippe |
author_facet | Meunier, Lucy Sanavio, Mathilde Dumortier, Jérôme Meszaros, Magdalena Faure, Stéphanie Ursic Bedoya, José Echenne, Maxime Boillot, Olivier Debourdeau, Antoine Pageaux, Georges Philippe |
author_sort | Meunier, Lucy |
collection | PubMed |
description | BACKGROUND AND AIMS: After 2 doses, the efficacy of anti‐SARS‐CoV‐2 vaccination seems to be lower in solid organ transplant recipients than in the immunocompetent population. The objective of this study was to determine the humoral response rate after vaccination, including with a booster dose, and to identify risk factors for non‐responsiveness in liver transplant recipients. METHODS: We included all patients seen in consultation in two French liver transplant centres between January 1, 2021, and March 15, 2021. RESULTS: 598 liver transplant recipients were enrolled and 327 were included for analysis. Sixteen patients received one dose, 63 patients two doses and 248 patients three doses. Anti‐SARS‐Cov‐2 antibodies were detected in 242 out of 327 (74.0%) liver transplant patients after vaccination. Considering an optimal serologic response defined as an antibody titre >260 BAU/ml, 172 patients (52.6%) were responders. Mycophenolate mofetil (MMF) treatment was an independent risk factor for a failure to develop anti‐SARS‐CoV‐2 antibodies after vaccination (OR 0.458; 95%CI 0.258–0.813; p = .008). Conversely, male gender (OR 2.247, 95%CI 1.194–4.227; p = .012) and receiving an mRNA vaccine (vs a non‐mRNA vaccine) (OR 4.107, 95%CI 1.145–14.731; p = .030) were independent predictive factors for developing an optimal humoral response after vaccination. None of the patients who received the vaccine experienced any serious adverse events. CONCLUSIONS: Even after a third booster dose, response rate to vaccination is decreased in liver transplant recipients. MMF appears to be a major determinant of seroconversion and optimal response to vaccination in these patients. |
format | Online Article Text |
id | pubmed-9115190 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91151902022-05-18 Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients Meunier, Lucy Sanavio, Mathilde Dumortier, Jérôme Meszaros, Magdalena Faure, Stéphanie Ursic Bedoya, José Echenne, Maxime Boillot, Olivier Debourdeau, Antoine Pageaux, Georges Philippe Liver Int Cirrhosis, Liver Failure and Transplantation BACKGROUND AND AIMS: After 2 doses, the efficacy of anti‐SARS‐CoV‐2 vaccination seems to be lower in solid organ transplant recipients than in the immunocompetent population. The objective of this study was to determine the humoral response rate after vaccination, including with a booster dose, and to identify risk factors for non‐responsiveness in liver transplant recipients. METHODS: We included all patients seen in consultation in two French liver transplant centres between January 1, 2021, and March 15, 2021. RESULTS: 598 liver transplant recipients were enrolled and 327 were included for analysis. Sixteen patients received one dose, 63 patients two doses and 248 patients three doses. Anti‐SARS‐Cov‐2 antibodies were detected in 242 out of 327 (74.0%) liver transplant patients after vaccination. Considering an optimal serologic response defined as an antibody titre >260 BAU/ml, 172 patients (52.6%) were responders. Mycophenolate mofetil (MMF) treatment was an independent risk factor for a failure to develop anti‐SARS‐CoV‐2 antibodies after vaccination (OR 0.458; 95%CI 0.258–0.813; p = .008). Conversely, male gender (OR 2.247, 95%CI 1.194–4.227; p = .012) and receiving an mRNA vaccine (vs a non‐mRNA vaccine) (OR 4.107, 95%CI 1.145–14.731; p = .030) were independent predictive factors for developing an optimal humoral response after vaccination. None of the patients who received the vaccine experienced any serious adverse events. CONCLUSIONS: Even after a third booster dose, response rate to vaccination is decreased in liver transplant recipients. MMF appears to be a major determinant of seroconversion and optimal response to vaccination in these patients. John Wiley and Sons Inc. 2022-04-02 2022-08 /pmc/articles/PMC9115190/ /pubmed/35338550 http://dx.doi.org/10.1111/liv.15258 Text en © 2022 The Authors. Liver International published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Cirrhosis, Liver Failure and Transplantation Meunier, Lucy Sanavio, Mathilde Dumortier, Jérôme Meszaros, Magdalena Faure, Stéphanie Ursic Bedoya, José Echenne, Maxime Boillot, Olivier Debourdeau, Antoine Pageaux, Georges Philippe Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title | Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title_full | Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title_fullStr | Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title_full_unstemmed | Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title_short | Mycophenolate mofetil decreases humoral responses to three doses of SARS‐CoV‐2 vaccine in liver transplant recipients |
title_sort | mycophenolate mofetil decreases humoral responses to three doses of sars‐cov‐2 vaccine in liver transplant recipients |
topic | Cirrhosis, Liver Failure and Transplantation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115190/ https://www.ncbi.nlm.nih.gov/pubmed/35338550 http://dx.doi.org/10.1111/liv.15258 |
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