Department of Kidney Transplant Surgery, Sapporo City General Hospital, Sapporo, Japan.
Department of Kidney Transplant Surgery, Sapporo City General Hospital, Sapporo, Japan.
Transplant Proc. 2023 Apr;55(3):514-520. doi: 10.1016/j.transproceed.2023.02.018. Epub 2023 Feb 27.
To investigate the kinetics and durability of anti-spike glycoprotein (S) immunoglobulin G (IgG) after the second dose of mRNA-based SARS-CoV-2 vaccine in kidney transplant recipients (recipients) compared with those in kidney donors (donors) and healthy volunteers (HVs) and identify factors negatively associated with SARS-CoV-2 vaccine effectiveness in recipients.
We enrolled 378 recipients with no history of COVID-19 and no anti-S-IgG before the first vaccine and who received a second mRNA-based vaccine dose. Antibodies were detected using an immunoassay more than 4 weeks after the second vaccine dose. Anti-S-IgG <0.8, ≥0.8 to 15, and ≥15 U/mL were considered negative, weak positive, and strongly positive, respectively, whereas anti-nucleocapsid protein IgG was negative. Anti-S-IgG titer was determined in 990 HVs and 102 donors.
Anti-S-IgG titers were 154, 2475, and 1181 U/mL in the recipient, HV, and donor groups, respectively, with values significantly lower in recipients. The anti-S-IgG-positivity rate of recipients gradually increased following the second vaccination, suggesting that recipients had a delayed response compared with the HV and donor groups, who had a 100% positivity rate at an earlier time point. Anti-S-IgG titers decreased in donors and HVs, whereas they remained stable in recipients, although at a significantly lower level. Independent negative factors associated with anti-S-IgG titers in recipients were age >60 years and lymphocytopenia (odds ratio: 2.35 and 2.44, respectively).
Kidney transplant recipients demonstrate delayed and attenuated responses, with lower SARS-CoV-2 antibody titers after the second dose of the mRNA-based COVID-19 vaccine.
研究与肾供体（供体）和健康志愿者（HV）相比，肾移植受者（受者）在接受第二剂基于 mRNA 的 SARS-CoV-2 疫苗后，抗刺突糖蛋白（S）免疫球蛋白 G（IgG）的动力学和持久性，并确定与受者中 SARS-CoV-2 疫苗有效性负相关的因素。
我们招募了 378 名没有 COVID-19 病史且在第一剂疫苗前没有抗-S-IgG 的受者，并接受了第二剂基于 mRNA 的疫苗。在第二剂疫苗接种后 4 周以上使用免疫测定法检测抗体。抗-S-IgG<0.8、≥0.8 至 15 和≥15 U/mL 分别被认为是阴性、弱阳性和强阳性，而抗核衣壳蛋白 IgG 是阴性的。在 990 名 HV 和 102 名供体中测定了抗-S-IgG 滴度。
受者、HV 和供体组的抗-S-IgG 滴度分别为 154、2475 和 1181 U/mL，受者的滴度明显较低。随着第二次接种，受者的抗-S-IgG 阳性率逐渐增加，这表明与 HV 和供体组相比，受者的反应较慢，HV 和供体组在更早的时间点达到了 100%的阳性率。供体和 HV 中的抗-S-IgG 滴度下降，而受者中的抗-S-IgG 滴度保持稳定，尽管水平明显较低。与受者抗-S-IgG 滴度相关的独立负因素是年龄>60 岁和淋巴细胞减少症（比值比：2.35 和 2.44）。
肾移植受者表现出延迟和减弱的反应，在接受基于 mRNA 的 COVID-19 疫苗第二剂后，SARS-CoV-2 抗体滴度较低。
