Nephrology Department, Tel-Aviv Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Organ Transplantation Unit, Tel-Aviv Medical Center, Tel-Aviv, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Organ Transplantation Unit, Tel-Aviv Medical Center, Tel-Aviv, Israel; Liver Unit, Gastroenterology Institute, Tel Aviv Medical Center, Tel-Aviv, Israel.
Transplant Proc. 2022 Jul-Aug;54(6):1439-1445. doi: 10.1016/j.transproceed.2022.02.011. Epub 2022 Mar 1.
Most solid organ transplant recipients did not develop an appreciable serologic response after 2 doses of the mRNA SARS-CoV-2 vaccine.
We analyzed the humoral response after a third dose of the BNT162b2 vaccine in 130 kidney transplant recipients, compared to 48 health care workers, and associated factors, including prevaccine cellular immune response, by evaluating intracellular cytokine production after stimulation of donor's peripheral blood mononuclear cells.
After 2 doses, most of the controls (47 out of 48, 98%) and only 40% of kidney recipients (52 of 130) kidney recipients were seropositive (P < .001). Most seronegative recipients developed a serologic response after the booster (47 out 78, 60%), thus bringing the total number of seropositive recipients to 99 out of 130 (76%). After the third dose, there was a significant increase in antibodies titers in both groups. Decreased humoral response was significantly associated with an older age, lower lymphocyte count, and a lower level of antibodies before booster administration. CD4TNFα and CD4INFγ were correlated with mean increase in antibody titers.
A third dose of the BNT162b2 mRNA vaccine in kidney recipients is safe and effectively results in increased IgG anti-S levels, including in individuals who were seronegative after 2 doses. Long-term studies of the length of the immune response and protection are required.
大多数实体器官移植受者在接种 2 剂 mRNA SARS-CoV-2 疫苗后未产生明显的血清学反应。
我们分析了 130 例肾移植受者在接种第三剂 BNT162b2 疫苗后的体液反应，并与 48 名医护人员进行了比较，还评估了供体外周血单个核细胞刺激后细胞内细胞因子的产生，以评估细胞免疫反应。
接种 2 剂后，大多数对照者（48 例中的 47 例，98%）和仅 40%的肾移植受者（130 例中的 52 例）为血清阳性（P<0.001）。大多数血清阴性的受者在加强针后产生了血清学反应（78 例中的 47 例，60%），因此，130 例受者中有 99 例（76%）为血清阳性。接种第三剂后，两组的抗体滴度均显著增加。体液反应下降与年龄较大、淋巴细胞计数较低和加强针前抗体水平较低显著相关。CD4TNFα 和 CD4INFγ 与抗体滴度的平均增加呈正相关。
在肾移植受者中接种第三剂 BNT162b2 mRNA 疫苗是安全且有效的，可使 IgG 抗-S 水平升高，包括在接种 2 剂后血清阴性的个体。需要进行长期研究以了解免疫反应和保护作用的持续时间。
