Jang Hye-Won, Bae Seongman, Ko Youngmin, Lim Seong Jun, Kwon Hye Eun, Jung Joo Hee, Cho Hae Yon, Go Heounjeong, Kwon Hyunwook, Kim Young Hoon, Kim Sung-Han, Shin Sung
Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Transplant. 2021 Dec 31;35(4):253-256. doi: 10.4285/kjt.21.0025.
The impact of the coronavirus disease 2019 (COVID-19) vaccination on humoral and cellular immunity in transplant recipients remains unknown. We report the case of a 78-year-old kidney transplant recipient who experienced acute T cell-mediated rejection after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). She had no history of acute rejection throughout the 13 years after deceased donor kidney transplantation. Fifteen days after receiving the second dose of the BNT162b2 vaccine, the recipient visited our center with a mild headache and fever. Her serum creatinine level had increased from 0.61 to 4.95 mg/dL. Kidney allograft biopsy indicated acute T cell-mediated rejection (grade IB) with no pathologic evidence of antibody-mediated rejection. Anti-severe acute respiratory syndrome coronavirus 2 spike-immunoglobulin G and -immunoglobulin M measurements were weak positive and negative, respectively. Careful monitoring of kidney allograft function is vital for transplant recipients undergoing COVID-19 vaccination.
2019冠状病毒病（COVID-19）疫苗接种对移植受者体液免疫和细胞免疫的影响尚不清楚。我们报告了一例78岁肾移植受者的病例，该受者在接种第二剂BNT162b2 mRNA COVID-19疫苗（辉瑞-生物科技公司）后发生了急性T细胞介导的排斥反应。在接受已故供体肾移植后的13年里，她没有急性排斥反应史。在接种第二剂BNT162b2疫苗15天后，该受者因轻度头痛和发热前来我们中心就诊。她的血清肌酐水平从0.61 mg/dL升至4.95 mg/dL。肾移植活检显示为急性T细胞介导的排斥反应（1B级），无抗体介导的排斥反应的病理证据。抗严重急性呼吸综合征冠状病毒2刺突免疫球蛋白G和免疫球蛋白M检测分别为弱阳性和阴性。对于接受COVID-19疫苗接种的移植受者，仔细监测肾移植功能至关重要。
