Mita Atsuyoshi, Ohno Yasunari, Masuda Yuichi, Yoshizawa Kazuki, Kubota Koji, Notake Tsuyoshi, Shimizu Akira, Matsunami Hidetoshi, Soejima Yuji
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery Shinshu University School of Medicine Matsumoto Japan.
Matsunami General Hospital Gifu Japan.
Ann Gastroenterol Surg. 2023 Apr 19;7(5):800-807. doi: 10.1002/ags3.12677. eCollection 2023 Sep.
INTRODUCTION: The mRNA-based vaccine was released as a COVID-19 prophylactic; however, its efficacy in organ transplant recipients is unknown. This study aimed to clarify this in liver transplant recipients. METHODS: Herein, liver transplant recipients from two hospitals who received vaccines were included. Immunoglobulin-G antibodies against the spike and nucleocapsid proteins were measured chronologically after the second, third, and fourth vaccine doses. RESULTS: Antibody levels in 125 liver transplant recipients and 20 healthy volunteers were analyzed. The median age at transplant was 35 (interquartile range 1, 53) years, and the period between transplant and the first dose was 15.2 ± 7.7 years. After the second and third doses, 89.1% and 100% of recipients displayed a positive humoral response, respectively. Anti-spike antibodies after the second dose were significantly reduced at 3 and 6 months, compared to that at 1 month (26.0 [5.4, 59.5], 14.7 [6.5, 31.4] vs. 59.7 [18.3, 164.0] AU/mL, respectively, < 0.0001). However, a booster vaccine significantly elevated anti-spike antibodies in LT recipients ( < 0.0001) as well as in healthy controls ( < 0.0001). Additionally, the decay rate was comparable between the transplant recipients and controls (2.1 [0.8, 4.5] vs. 2.7 [1.1, 4.1] AU/mL/day, = 0.9359). Only 4.0% of vaccinated transplant recipients were positive for anti-nucleocapsid antibodies. CONCLUSION: Liver transplant recipients can acquire immunity similar to that of healthy people through vaccination against SARS-CoV-2. The antibody decay rate is the same, and booster vaccinations should be administered similarly to that in healthy individuals.
引言:基于信使核糖核酸的疫苗作为新冠病毒预防性疫苗已获批使用;然而,其在器官移植受者中的疗效尚不清楚。本研究旨在阐明肝移植受者的这一情况。 方法:纳入了两家医院接种疫苗的肝移植受者。在接种第二、第三和第四剂疫苗后,按时间顺序检测针对刺突蛋白和核衣壳蛋白的免疫球蛋白G抗体。 结果:分析了125名肝移植受者和20名健康志愿者的抗体水平。移植时的中位年龄为35岁(四分位间距1,53),移植与第一剂疫苗接种之间的时间为15.2±7.7年。在接种第二剂和第三剂疫苗后,分别有89.1%和100%的受者出现了阳性体液反应。与接种1个月时相比,接种第二剂疫苗后3个月和6个月时的抗刺突抗体显著降低(分别为26.0[5.4,59.5]、14.7[6.5,31.4]与59.7[18.3,164.0]AU/mL,P<0.0001)。然而,加强疫苗显著提高了肝移植受者(P<0.0001)以及健康对照者(P<0.0001)的抗刺突抗体水平。此外,移植受者和对照者之间的抗体衰减率相当(2.1[0.8,4.5]与2.7[1.1,4.1]AU/mL/天,P=0.9359)。接种疫苗的移植受者中只有4.0%的抗核衣壳抗体呈阳性。 结论:肝移植受者通过接种新冠疫苗可获得与健康人相似的免疫力。抗体衰减率相同,加强疫苗接种应与健康个体类似。
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