National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Surgery, Hiroshima, Japan.
National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Surgery, Hiroshima, Japan; National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Clinical Research, Hiroshima, Japan.
Transplant Proc. 2023 May;55(4):815-819. doi: 10.1016/j.transproceed.2023.04.003. Epub 2023 Apr 7.
This study confirmed the kinetics of antibodies acquired by SARS-CoV-2 vaccination in solid-organ transplant recipients and examined their association with the development of COVID-19 and immunosuppressive status in organ transplant recipients.
We measured COVID-19 neutralizing antibody titer in 21 organ transplant recipients vaccinated with the COVID-19 vaccine and 14 nontransplant recipients (control group) 3 times before and at 1 and 6 months after the third dose of vaccine. By confirming the kinetics of the acquired antibodies, we examined the relevance of the background characteristics of organ transplant recipients, such as the development of infectious diseases and immunosuppressive status.
The proportion of patients with neutralizing antibodies was significantly higher in the nontransplant group than in the transplant group. Neutralizing antibody titers were significantly lower in transplant recipients when they were compared before the third dose and 1 month later. In the transplant recipient group, 11 patients were positive, and 10 were negative for neutralizing antibodies. When the causal relationship between the neutralizing antibody titer and background was examined, a positive correlation was found between the antibody titer and the number of years since transplantation, and a negative correlation was found between the tacrolimus trough values, amount of mycophenolate mofetil or steroids taken internally, and antibody titer.
This study suggests that the effectiveness of vaccination in transplant recipients is associated with the post-transplant period before vaccination and the dose of immunosuppressive agents.
本研究证实了 SARS-CoV-2 疫苗接种在实体器官移植受者中产生的抗体动力学，并研究了其与 COVID-19 的发生和器官移植受者免疫抑制状态的关系。
我们在 COVID-19 疫苗接种的 21 名器官移植受者和 14 名非移植受者（对照组）接种疫苗前 3 次和第 3 次疫苗接种后 1 个月和 6 个月测量了 COVID-19 中和抗体滴度。通过确认获得的抗体的动力学，我们检查了器官移植受者的背景特征，如传染病的发生和免疫抑制状态的相关性。
非移植组的中和抗体阳性患者比例明显高于移植组。与第 3 次剂量前和 1 个月后相比，移植受者的中和抗体滴度显著降低。在移植受者组中，11 例为中和抗体阳性，10 例为阴性。当检查中和抗体滴度与背景之间的因果关系时，发现抗体滴度与移植后时间的长短呈正相关，与他克莫司谷值、霉酚酸酯或内部服用的类固醇剂量呈负相关。
本研究表明，疫苗接种在移植受者中的有效性与接种前的移植后时期和免疫抑制剂剂量有关。
