Nephrology Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Clin Transplant. 2022 Apr;36(4):e14585. doi: 10.1111/ctr.14585. Epub 2022 Jan 18.
Vaccination is a promising strategy to control the ongoing pandemic; however, solid organ recipients tend to develop a weaker immune response to vaccination. Anti-spike SARS-CoV-2 antibodies titers were measured 2-4 weeks post-vaccination completion in 131 KT patients without previous infection. Demographic, clinical, and laboratorial parameters were analyzed to identify which factors contributed to seroconversion. Factors that influenced seroconversion, that occurred in 76 patients (58%), were longer time post-transplant, immunosuppression without an antiproliferative drug and vaccination with mRNA vaccines. Patients who received mRNA vaccines had significantly higher rates of seroconversion compared with adenovirus vector vaccines (67% vs 33%, P < .001) and higher anti-spike IgG titers. These findings reinforce the need to discuss the vaccination strategy in this population, including a third dose with a mRNA vaccine.
接种疫苗是控制当前大流行的一种有前途的策略；然而，实体器官受者往往对疫苗接种产生较弱的免疫反应。在 131 名未感染过的 KT 患者中，在接种疫苗完成后 2-4 周测量了抗尖峰 SARS-CoV-2 抗体滴度。分析了人口统计学、临床和实验室参数，以确定哪些因素有助于血清转化率。在 76 名患者（58%）中发生的影响血清转化率的因素是移植后时间较长、无抗增殖药物的免疫抑制以及 mRNA 疫苗接种。与腺病毒载体疫苗（67%比 33%，P<.001）相比，接种 mRNA 疫苗的患者血清转化率显著更高，且抗尖峰 IgG 滴度更高。这些发现强调了需要讨论该人群的疫苗接种策略，包括使用 mRNA 疫苗接种第三剂。
