Department of Nephrology, Kameda Medical Center, Chiba, Japan; Renal Transplant Center, Kameda Medical Center, Chiba, Japan.
Department of Nephrology, Kameda Medical Center, Chiba, Japan; Renal Transplant Center, Kameda Medical Center, Chiba, Japan.
Transplant Proc. 2022 Jul-Aug;54(6):1483-1488. doi: 10.1016/j.transproceed.2022.05.002. Epub 2022 May 31.
The immune response to COVID-19 vaccination in kidney transplant (KTx) recipients is significantly lower than that in healthy controls. We evaluated immune responses after the COVID-19 vaccine and their possible relationship with other cofactors in KTx recipients.
This retrospective single-center cohort study included 29 KTx recipients 2-8 weeks after receiving 2 doses of the Pfizer-BioNTech SARS-CoV-2 messenger RNA vaccine. Anti-SARS-CoV-2 spike (S) immunoglobulin (Ig)-G levels were evaluated to define cofactors influencing the immune response between the responder (anti-SARS-CoV-2 IgG level ≥0.8 U/mL) (n = 16) and nonresponder groups (anti-SARS-CoV-2 IgG level <0.8 U/mL) (n = 13). The kinetics of antibodies between 2 and 6 months after the second vaccination was also compared between the groups.
KTx recipients with IgG levels ≥0.8 U/mL were younger (54 [interquartile range {IQR}, 46.5-61] years vs 65 [IQR, 55-71.5] years; P = .01), had been transplanted for a longer median time (1588 [IQR, 1382-4751] days vs 1034 [IQR, 548.5-1833] days; P = .02), and were more often treated with a lower mycophenolate mofetil dosage (765.6 ± 119.6 vs 1077 ± 76.9 mg; P = .04) than KTx recipients with IgG levels <0.8 U/mL. There was no significant difference in antibody titers between time periods after the second dose in the responder group. At the 6-month follow-up, a serologic response against the SARS-CoV-2 S was observed in 44.4% of KTx recipients in the nonresponder group.
More than 50% of KTx recipients developed a higher antibody response after the second dose of COVID-19 vaccination.
肾移植（KTx）受者对 COVID-19 疫苗的免疫反应明显低于健康对照者。我们评估了 COVID-19 疫苗接种后的免疫反应及其与 KTx 受者其他因素的可能关系。
这是一项回顾性单中心队列研究，纳入了 29 例接受 2 剂辉瑞-生物科技 SARS-CoV-2 信使 RNA 疫苗 2-8 周后的 KTx 受者。评估抗 SARS-CoV-2 刺突（S）免疫球蛋白（Ig）-G 水平，以确定影响应答者（抗 SARS-CoV-2 IgG 水平≥0.8 U/mL）（n=16）和无应答者组（抗 SARS-CoV-2 IgG 水平<0.8 U/mL）（n=13）之间免疫反应的相关因素。还比较了两组患者在第二次接种疫苗后 2 至 6 个月期间抗体的动力学。
IgG 水平≥0.8 U/mL 的 KTx 受者更年轻（54[四分位间距{IQR}，46.5-61]岁 vs 65[IQR，55-71.5]岁；P=0.01）、移植时间中位数更长（1588[IQR，1382-4751]天 vs 1034[IQR，548.5-1833]天；P=0.02）、更常接受较低剂量的霉酚酸酯（765.6±119.6 vs 1077±76.9 mg；P=0.04）。与 IgG 水平<0.8 U/mL 的 KTx 受者相比，应答者组第二次接种后不同时间点的抗体滴度无显著差异。在 6 个月的随访中，无应答者组有 44.4%的 KTx 受者对 SARS-CoV-2 S 产生了血清学反应。
超过 50%的 KTx 受者在接受 COVID-19 疫苗第二剂后产生了更高的抗体反应。
