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Humoral response to SARS-CoV-2 mRNA vaccination in previous non-responder kidney transplant recipients after short-term withdrawal of mycophenolic acid

Seroconversion rates after COVID-19 vaccination are significantly lower in kidney transplant recipients compared to healthy cohorts. Adaptive immunization strategies are needed to protect these patients from COVID-19. In this prospective observational cohort study, we enrolled 76 kidney transplant r...

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Main Authors: Benning, Louise (Author) , Morath, Christian (Author) , Kühn, Tessa (Author) , Bartenschlager, Marie (Author) , Kim, Heeyoung (Author) , Beimler, Jörg (Author) , Buylaert, Mirabel (Author) , Nußhag, Christian (Author) , Kälble, Florian (Author) , Reineke, Marvin (Author) , Töllner, Maximilian (Author) , Schaier, Matthias (Author) , Klein, Katrin (Author) , Blank, Antje (Author) , Schnitzler, Paul (Author) , Zeier, Martin (Author) , Süsal, Caner (Author) , Bartenschlager, Ralf (Author) , Tran, Thuong Hien (Author) , Speer, Claudius (Author)
Format: Article (Journal)
Language:English
Published: 18 August 2022
In: Frontiers in medicine
Year: 2022, Volume: 9, Pages: 1-12
ISSN:2296-858X
DOI:10.3389/fmed.2022.958293
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3389/fmed.2022.958293
Verlag, lizenzpflichtig, Volltext: https://www.webofscience.com/api/gateway?GWVersion=2&SrcAuth=DynamicDOIArticle&SrcApp=WOS&KeyAID=10.3389%2Ffmed.2022.958293&DestApp=DOI&SrcAppSID=EUW1ED0B98e4azhs9sdTI2Wugegva&SrcJTitle=FRONTIERS+IN+MEDICINE&DestDOIRegistrantName=Frontiers+Media+SA
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Author Notes:Louise Benning, Christian Morath, Tessa Kuehn, Marie Bartenschlager, Heeyoung Kim, Joerg Beimler, Mirabel Buylaert, Christian Nusshag, Florian Kaelble, Marvin Reineke, Maximilian Toellner, Matthias Schaier, Katrin Klein, Antje Blank, Paul Schnitzler, Martin Zeier, Caner Suesal, Ralf Bartenschlager, Thuong Hien Tran, Claudius Speer
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Summary:Seroconversion rates after COVID-19 vaccination are significantly lower in kidney transplant recipients compared to healthy cohorts. Adaptive immunization strategies are needed to protect these patients from COVID-19. In this prospective observational cohort study, we enrolled 76 kidney transplant recipients with no seroresponse after at least three COVID-19 vaccinations to receive an additional mRNA-1273 vaccination (full dose, 100 mu g). Mycophenolic acid was withdrawn in 43 selected patients 5-7 days prior to vaccination and remained paused for 4 additional weeks after vaccination. SARS-CoV-2-specific antibodies and neutralization of the delta and omicron variants were determined using a live-virus assay 4 weeks after vaccination. In patients with temporary mycophenolic acid withdrawal, donor-specific anti-HLA antibodies and donor-derived cell-free DNA were monitored before withdrawal and at follow-up. SARS-CoV-2 specific antibodies significantly increased in kidney transplant recipients after additional COVID-19 vaccination. The effect was most pronounced in individuals in whom mycophenolic acid was withdrawn during vaccination. Higher SARS-CoV-2 specific antibody titers were associated with better neutralization of SARS-CoV-2 delta and omicron variants. In patients with short-term withdrawal of mycophenolic acid, graft function and donor-derived cell-free DNA remained stable. No acute rejection episode occurred during short-term follow-up. However, resurgence of prior anti-HLA donor-specific antibodies was detected in 7 patients.
Item Description:Gesehen am 27.10.2022
Physical Description:Online Resource
ISSN:2296-858X
DOI:10.3389/fmed.2022.958293

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