SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response

Kidney transplant recipients are at increased risk of SARS-CoV-2 infection and a more severe course of COVID-19. METHODS. We conducted a quantitative serologic testing of antibodies specific for the wild type of SARS-CoV-2 and the Omicron variant of concern before and after a third-dose vaccination,...

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Autores principales: Lammert, Alexander, Schnuelle, Peter, Rabenau, Holger F., Ciesek, Sandra, Krämer, Bernhard K., Göttmann, Uwe, Drüschler, Felix, Keller, Christine, Rose, Daniela, Blume, Carsten, Thomas, Michael, Kohmer, Niko, Lammert, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575732/
https://www.ncbi.nlm.nih.gov/pubmed/36259077
http://dx.doi.org/10.1097/TXD.0000000000001384
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author Lammert, Alexander
Schnuelle, Peter
Rabenau, Holger F.
Ciesek, Sandra
Krämer, Bernhard K.
Göttmann, Uwe
Drüschler, Felix
Keller, Christine
Rose, Daniela
Blume, Carsten
Thomas, Michael
Kohmer, Niko
Lammert, Anne
author_facet Lammert, Alexander
Schnuelle, Peter
Rabenau, Holger F.
Ciesek, Sandra
Krämer, Bernhard K.
Göttmann, Uwe
Drüschler, Felix
Keller, Christine
Rose, Daniela
Blume, Carsten
Thomas, Michael
Kohmer, Niko
Lammert, Anne
author_sort Lammert, Alexander
collection PubMed
description Kidney transplant recipients are at increased risk of SARS-CoV-2 infection and a more severe course of COVID-19. METHODS. We conducted a quantitative serologic testing of antibodies specific for the wild type of SARS-CoV-2 and the Omicron variant of concern before and after a third-dose vaccination, either mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) in a cohort of 103 stable kidney transplant recipients (median [range] age, 58 [22–84] y, 57 men [55.3%]). RESULTS. Third-dose vaccination increased the seroconversion rate from 57.3% to 71.8%. However, despite a marked rise of the antibody concentrations after the booster, 55.4% and 11.6% only formed neutralizing antibodies against the SARS-CoV-2 wild type and Omicron, respectively. Treatment with mycophenolic acid/mycophenolate mofetil (in strata of the dose quartiles), advanced age, and‚ above all‚ impaired renal function (eGFR <60 mL/min) adversely influenced the humoral immunity regarding seroconversion and inhibition of the wild type of SARS-CoV-2. CONCLUSIONS. Apart from immunosuppressive therapy, the humoral vaccination response is largely affected by nonmodifiable factors in kidney transplant recipients. With the currently leading and clinically easier Omicron variant, this puts into perspective the strategy to significantly enhance the protective efficacy of the available vaccines by reducing or temporarily stopping proliferation inhibitors, not least considering the inherent rejection risk with a possible deterioration of graft function.
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spelling pubmed-95757322022-10-17 SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response Lammert, Alexander Schnuelle, Peter Rabenau, Holger F. Ciesek, Sandra Krämer, Bernhard K. Göttmann, Uwe Drüschler, Felix Keller, Christine Rose, Daniela Blume, Carsten Thomas, Michael Kohmer, Niko Lammert, Anne Transplant Direct Infectious Disease Kidney transplant recipients are at increased risk of SARS-CoV-2 infection and a more severe course of COVID-19. METHODS. We conducted a quantitative serologic testing of antibodies specific for the wild type of SARS-CoV-2 and the Omicron variant of concern before and after a third-dose vaccination, either mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) in a cohort of 103 stable kidney transplant recipients (median [range] age, 58 [22–84] y, 57 men [55.3%]). RESULTS. Third-dose vaccination increased the seroconversion rate from 57.3% to 71.8%. However, despite a marked rise of the antibody concentrations after the booster, 55.4% and 11.6% only formed neutralizing antibodies against the SARS-CoV-2 wild type and Omicron, respectively. Treatment with mycophenolic acid/mycophenolate mofetil (in strata of the dose quartiles), advanced age, and‚ above all‚ impaired renal function (eGFR <60 mL/min) adversely influenced the humoral immunity regarding seroconversion and inhibition of the wild type of SARS-CoV-2. CONCLUSIONS. Apart from immunosuppressive therapy, the humoral vaccination response is largely affected by nonmodifiable factors in kidney transplant recipients. With the currently leading and clinically easier Omicron variant, this puts into perspective the strategy to significantly enhance the protective efficacy of the available vaccines by reducing or temporarily stopping proliferation inhibitors, not least considering the inherent rejection risk with a possible deterioration of graft function. Lippincott Williams & Wilkins 2022-10-14 /pmc/articles/PMC9575732/ /pubmed/36259077 http://dx.doi.org/10.1097/TXD.0000000000001384 Text en Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Infectious Disease
Lammert, Alexander
Schnuelle, Peter
Rabenau, Holger F.
Ciesek, Sandra
Krämer, Bernhard K.
Göttmann, Uwe
Drüschler, Felix
Keller, Christine
Rose, Daniela
Blume, Carsten
Thomas, Michael
Kohmer, Niko
Lammert, Anne
SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title_full SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title_fullStr SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title_full_unstemmed SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title_short SARS-CoV-2 Vaccination in Kidney Transplant Recipients—Stratified Analysis of the Humoral Immune Response
title_sort sars-cov-2 vaccination in kidney transplant recipients—stratified analysis of the humoral immune response
topic Infectious Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575732/
https://www.ncbi.nlm.nih.gov/pubmed/36259077
http://dx.doi.org/10.1097/TXD.0000000000001384
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