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Transpl Infect Dis . Immune response, phenotyping and molecular graft surveillance in kidney transplant recipients following severe acute respirato

tetano

Editor, Senior Moderator
Transpl Infect Dis


. 2023 Sep 14;e14122.
doi: 10.1111/tid.14122. Online ahead of print. Immune response, phenotyping and molecular graft surveillance in kidney transplant recipients following severe acute respiratory syndrome coronavirus 2 vaccination

Nicole M Ali[SUP] #[/SUP][SUP] 1 2 [/SUP], Ramin S Herati[SUP] #[/SUP][SUP] 2 [/SUP], Sapna A Mehta[SUP] 1 2 [/SUP], Jeanette Leonard[SUP] 1 [/SUP], Jake Miles[SUP] 3 [/SUP], Bonnie E Lonze[SUP] 1 4 [/SUP], Charles DiMaggio[SUP] 4 [/SUP], Vasishta S Tatapudi[SUP] 1 2 [/SUP], Zoe A Stewart[SUP] 1 4 [/SUP], Nasser Alnazari[SUP] 1 [/SUP], Henry J Neumann[SUP] 1 2 [/SUP], Jeffrey Thomas[SUP] 1 [/SUP], Katarzyna Cartiera[SUP] 1 [/SUP], Elaina Weldon[SUP] 1 [/SUP], Jennifer Michael[SUP] 1 [/SUP], Christopher Hickson[SUP] 1 [/SUP], Harris Whiteson[SUP] 1 [/SUP], Karen Khalil[SUP] 1 [/SUP], Jeffrey M Stern[SUP] 1 4 [/SUP], Joseph R Allen[SUP] 2 [/SUP], Michael Tuen[SUP] 2 [/SUP], Sophie L Gray-Gaillard[SUP] 2 [/SUP], Sabrina M Solis[SUP] 2 [/SUP], Marie I Samanovic[SUP] 2 [/SUP], Mark J Mulligan[SUP] 2 [/SUP], Robert A Montgomery[SUP] 1 4 [/SUP]



Affiliations
Abstract

Background: Understanding immunogenicity and alloimmune risk following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in kidney transplant recipients is imperative to understanding the correlates of protection and to inform clinical guidelines.
Methods: We studied 50 kidney transplant recipients following SARS-CoV-2 vaccination and quantified their anti-spike protein antibody, donor-derived cell-free DNA (dd-cfDNA), gene expression profiling (GEP), and alloantibody formation.
Results: Participants were stratified using nucleocapsid testing as either SARS-CoV-2-naïve or experienced prior to vaccination. One of 34 (3%) SARS-CoV-2 naïve participants developed anti-spike protein antibodies. In contrast, the odds ratio for the association of a prior history of SARS-CoV-2 infection with vaccine response was 18.3 (95% confidence interval 3.2, 105.0, p < 0.01). Pre- and post-vaccination levels did not change for median dd-cfDNA (0.23% vs. 0.21% respectively, p = 0.13), GEP scores (9.85 vs. 10.4 respectively, p = 0.45), calculated panel reactive antibody, de-novo donor specific antibody status, or estimated glomerular filtration rate.
Conclusions: SARS-CoV-2 vaccines do not appear to trigger alloimmunity in kidney transplant recipients. The degree of vaccine immunogenicity was associated most strongly with a prior history of SARS-CoV-2 infection.

Keywords: SARS-CoV-2 vaccination; graft biomarker; immunogenicity.

 
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