Hepatology and Liver Transplantation Unit, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
Am J Transplant. 2021 Aug;21(8):2876-2884. doi: 10.1111/ajt.16599. Epub 2021 Apr 27.
The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case-control serological data were also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p < .001) and at 6 months (63.4% vs. 90.1%, p < .001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p = .001) and 6 months (p < .001) after COVID-19. In transplant patients, female gender (OR = 13.49, 95% CI: 2.17-83.8), a longer interval since transplantation (OR = 1.19, 95% CI: 1.03-1.36), and therapy with renin-angiotensin-aldosterone system inhibitors (OR = 7.11, 95% CI: 1.47-34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline.
在实体器官移植受者中，尚不清楚 SARS-CoV-2 感染后的体液免疫保护能力和持续时间。进行了一项前瞻性多中心研究，以评估 6 个月后冠状病毒病 2019（COVID-19）解决后肝移植受者抗核衣壳 IgG 抗体的持续存在。通过包含 COVID-19 中具有已知预后影响的变量的倾向评分，将 71 名肝移植受者与 71 名免疫功能正常的对照相匹配。在 COVID-19 后 3 个月和 6 个月时，还获得了 62 例肝移植患者和 62 例对照的配对病例对照血清学数据。肝移植受者在 3 个月（77.4%比 100%，p <.001）和 6 个月（63.4%比 90.1%，p <.001）时抗核衣壳 IgG 抗体的发生率较低。在 COVID-19 后 3 个月（p =.001）和 6 个月（p <.001）时，肝移植患者的抗体水平也较低。在移植患者中，女性（OR = 13.49，95%CI：2.17-83.8）、移植后时间间隔较长（OR = 1.19，95%CI：1.03-1.36）和肾素-血管紧张素-醛固酮系统抑制剂治疗（OR = 7.11，95%CI：1.47-34.50）与 COVID-19 后 6 个月以上抗体持续存在独立相关。因此，与免疫功能正常的患者相比，肝移植受者显示出较低的抗 SARS-CoV-2 抗体流行率和更明显的抗体水平下降。
