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Clin Transplant . A single-center review of outcomes between COVID-19 vaccinated and unvaccinated liver transplant recipients

tetano

Editor, Senior Moderator
Clin Transplant


. 2023 Nov 8:e15185.
doi: 10.1111/ctr.15185. Online ahead of print. A single-center review of outcomes between COVID-19 vaccinated and unvaccinated liver transplant recipients

Annelise Nolan[SUP] 1 [/SUP], Melissa McGowan[SUP] 1 [/SUP], Lauren Von Stein[SUP] 1 [/SUP], Adrienne Ross[SUP] 2 [/SUP], Manjit Kaur[SUP] 3 [/SUP], Todd Pesavento[SUP] 4 [/SUP], Priyamvada Singh[SUP] 4 [/SUP]



Affiliations
Abstract

Background: With the availability of vaccines against SARS-COV-2, recommendations for vaccination of transplant candidates are widespread. At our institution, patients may receive liver transplant (LTx) regardless of vaccine status. The purpose of this study is to compare post-LTx outcomes between vaccinated (VAX) and unvaccinated (UNVAX) LTx recipients.
Methods: This is a retrospective, single-center study of LTx from January 1, 2021-March 30, 2022. The primary outcome is incidence of post-LTx COVID-19. Secondary outcomes include graft function, mortality, graft loss, and COVID-19 treatment.
Results: One hundred and seventy-seven LTx recipients were included, 57% [101/177] VAX and 43% [76/177] UNVAX. Baseline characteristics were similar between groups. Overall, 28 (36.8%) UNVAX and 34 (33.7%) VAX tested COVID-19 positive during the study period (p = .193) at a mean of 312.6 [255.4-369.8] days for UNVAX versus 254.6 [215.2-293.9] days for VAX (p = .084). COVID-19 treatment was administered in 15 (53.6%) of the UNVAX compared to 22 (64.7%) in the VAX (p = .374), although eight (28.6%) of UNVAX required hospital admission for treatment compared with two (5.9%) of VAX (p = .016). There were no statistically significant differences in death, and no COVID-19 related death or graft loss. There were no statistically significant differences in liver function tests at 3- and 12-months post LTx.
Conclusion: In a series with a large percentage of UNVAX patients, LTx appears to be safe, with no difference in the rate of COVID-19 or transplant-related outcomes compared to VAX. While we encourage vaccination to prevent severe COVID, based on our results, vaccine status should not be reason to deny lifesaving transplant.

Keywords: COVID; SARS CoV-2vaccine; coronavirus; liver transplant.

 
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