National Coordination of the Donation and Transplant Network, Blood Bank, Transfusion, and Transplant Research Group, National Institute of Health, Bogotá, Colombia.
National Coordination of the Donation and Transplant Network, Blood Bank, Transfusion, and Transplant Research Group, National Institute of Health, Bogotá, Colombia.
Transplant Proc. 2023 Apr;55(3):500-507. doi: 10.1016/j.transproceed.2023.02.034. Epub 2023 Mar 1.
The huge impact of SARS-CoV-2 infections on organ transplant recipients makes it necessary to optimize vaccine efficacy in this population. To effectively implement multiple strategies, it is crucial to understand the performance of each type of available vaccine. In our study, the antibody titer was measured, and the presence of antibodies against SARS-CoV-2 was evaluated after 90 days of immunization; furthermore, the differences between hybrid immunity, immunity by vaccination, and immunosuppressant type were identified. As a result, of the patients included in this study (n = 160), 53% showed antibodies against SARS-CoV-2 90 days after the first dose in patients who had completed the vaccination schedule. Antibody titers were higher in patients with hybrid immunity, and the proportion of nonresponsive patients was higher among those who received the immunosuppressant belatacept in their post-transplant regimen (P = .01). Only 15% of patients treated with this medicine seroconverted and patients vaccinated with CoronaVac and treated with belatacept showed no response. In conclusion, a reduced response to vaccines against SARS-CoV-2 was identified in the transplant population, and this response varied with the type of vaccine administered and the immunosuppressive treatment.
SARS-CoV-2 感染对器官移植受者的巨大影响使得有必要优化该人群的疫苗效果。为了有效地实施多种策略,了解每种可用疫苗的性能至关重要。在我们的研究中,测量了抗体滴度,并在免疫接种 90 天后评估了针对 SARS-CoV-2 的抗体存在情况;此外,还确定了混合免疫、疫苗接种免疫和免疫抑制剂类型之间的差异。因此,在这项研究中包括的患者(n=160)中,53%的患者在完成疫苗接种计划后第 1 剂后 90 天显示出针对 SARS-CoV-2 的抗体。在具有混合免疫的患者中抗体滴度更高,而在移植后方案中接受免疫抑制剂贝利尤单抗的患者中无反应患者的比例更高(P=0.01)。仅 15%接受这种药物治疗的患者发生血清转化,并且用 CoronaVac 接种疫苗并用贝利尤单抗治疗的患者没有反应。总之,在移植人群中发现对 SARS-CoV-2 疫苗的反应降低,并且这种反应因所施用的疫苗类型和免疫抑制治疗而异。