与成人相比，儿童肝肾移植受者对SARS-CoV-2疫苗接种表现出更强的血清学反应。
Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults.
作者信息
Laue Tobias, Ballester Maria Pilar, Meoli Lily, Grabitz Carl, Uson Eva, D Antiga Lorenzo, McLin Valerie, Pujadas Montserrat, Carvalho-Gomes Ângela, Sahuco Ivan, Bono Ariadna, D'Amico Federico, Viganò Raffaela, Diago Elena, Lanseros Beatriz Tormo, Inglese Elvira, Vazquez Dani Martinez, Broekhoven Annelotte, Kikkert Marjolein, Morales Shessy P Torres, Myeni Sebenzile K, Riveiro-Barciela Mar, Palom Adriana, Zeni Nicola, Brocca Alessandra, Cussigh Annarosa, Cmet Sara, Escudero-García Maria Desamparados, Stocco Matteo, Natola Leonardo Antonio, Ieluzzi Donatella, Paon Veronica, Sangiovanni Angelo, Farina Elisa, Dibenedetto Clara, Sánchez-Torrijos Yolanda, Lucena-Varela Ana, Román Eva, Sánchez Elisabet, Sánchez-Aldehuelo Rubén, López-Cardona Julia, Jeyanesan Dhaarica, Morocho Alejandro Esquivel, Canas-Perez Itzel, Eastgate Christine, Di Cola Simone, Lapenna Lucia, Zaccherini Giacomo, Bongiovanni Deborah, Riva Antonio, Sharma Rajni, Tsou Hio Lam Phoebe, Harris Nicola, Zanaga Paola, Sayaf Katia, Hossain Sabir, Crespo Javier, Robles-Díaz Mercedes, Madejón Antonio, Degroote Helena, Korenjak Marko, Verhelst Xavier, García-Samaniego Javier, Andrade Raúl J, Iruzubieta Paula, Wright Gavin, Caraceni Paolo, Merli Manuela, Patel Vishal C, Gander Amir, Albillos Agustín, Soriano Germán, Donato Maria Francesca, Sacerdoti David, Toniutto Pierluigi, Buti Maria, Duvoux Christophe, Grossi Paolo Antonio, Berg Thomas, Polak Wojciech G, Puoti Massimo, Bosch-Comas Anna, Belli Luca S, Burra Patrizia, Russo Francesco Paolo, Coenraad Minneke, Calleja José Luis, Perricone Giovanni, Chokshi Shilpa, Berenguer Marina, Clària Joan, Moreau Richard, Fernández Javier, Arroyo Vicente, Angeli Paolo, Sánchez-Garrido Cristina, Ampuero Javier, Piano Salvatore, Nicastro Emanuele, Rock Nathalie, Shawcross Debbie, Edwards Lindsey, Mutschler Frauke, Melk Anette, Mehta Gautam, Baumann Ulrich, Jalan Rajiv
机构信息
Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
出版信息
Transplant Direct. 2025 Apr 29;11(5):e1787. doi: 10.1097/TXD.0000000000001787. eCollection 2025 May.
BACKGROUND
Adult solid organ transplant recipients (SOTRs) have decreased responsiveness to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination and higher incidence of infection, but there are few data on the serological response in pediatric SOTR. The aim of this study was to determine serological response to SARS-CoV-2 vaccination in pediatric liver (LT) and kidney transplant (KT) recipients and compare it with adult SOTR.
METHODS
A European, prospective, multicenter study was performed. Samples were taken at 7 and 32 wk following COVID-19 vaccination and serological endpoints were measured by ELISA.
RESULTS
A total of 42 pediatric (16 post-LT and 26 post-KT) and 117 adult (all post-LT) were included. All pediatric participants and 94% adult participants received mRNA vaccines. Paediatric SOTR patients had significantly higher anti-Spike IgG levels than adult participants at week 7 (114 220.7 [59 285.92-220 058.55] versus 8756.7 [5643.69-13 586.71], < 0.0001) and week 32 (46 113.2 [10 992.91-193 436.14] versus 8207.0 [3561.20-18 913.43], = 0.0032). No significant difference in week 7 anti-Spike IgG response was found between pediatric LT and KT (129 434.4 [51 888.64-322 869.69] versus 105 304.5 [39 910.20-277 849.50], = 0.9854). No differences were seen between children and adults in the rate of decline of anti-Spike IgG between weeks 7 and 32 ( = 0.8000). Male sex and hemolytic-uremic syndrome or postischemic kidney disease were associated with lower anti-Spike IgG levels at week 7 in pediatric SOTR.
CONCLUSIONS
Paediatric SOTR demonstrate greater SARS-CoV-2 vaccine responses than comparable adult SOTR patients. These data support efficacy and safety of SARS-CoV-2 vaccination in child SOTR and may alleviate vaccine hesitancy in this patient group.
背景
成人实体器官移植受者（SOTR）对严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）疫苗接种的反应性降低且感染发生率更高，但关于儿科SOTR血清学反应的数据较少。本研究的目的是确定儿科肝移植（LT）和肾移植（KT）受者对SARS-CoV-2疫苗接种的血清学反应，并将其与成人SOTR进行比较。
方法
进行了一项欧洲前瞻性多中心研究。在COVID-19疫苗接种后7周和32周采集样本，并通过酶联免疫吸附测定（ELISA）测量血清学终点指标。
结果
共纳入42名儿科患者（16名肝移植后患者和26名肾移植后患者）和117名成人患者（均为肝移植后患者）。所有儿科参与者和94%的成人参与者接种了mRNA疫苗。儿科SOTR患者在第7周（114 220.7[59 285.92 - 220 058.55]对8756.7[5643.⁶⁹ - 13 586.71]，P<0.0001）和第32周（46 113.2[10 992.91 - 193 436.14]对8207.0[3561.20 - 18 913.43]，P = 0.0032）的抗刺突蛋白IgG水平显著高于成人参与者。在第7周，儿科肝移植和肾移植患者之间的抗刺突蛋白IgG反应无显著差异（129 434.4[51 888.64 - 322 869.69]对105 304.5[39 910.20 - 277 849.50]，P = 0.9854）。在第7周和第32周之间，儿童和成人的抗刺突蛋白IgG下降率无差异（P = 0.8000）。在儿科SOTR中，男性以及溶血尿毒综合征或缺血后肾病与第7周较低的抗刺突蛋白IgG水平相关。
结论
儿科SOTR对SARS-CoV-2疫苗的反应比同龄成人SOTR患者更强。这些数据支持SARS-CoV-2疫苗在儿童SOTR中的有效性和安全性，并可能减轻该患者群体对疫苗的犹豫态度。
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