Antibody Response After a Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Liver Transplant Recipients

Sakai, Akiyoshi; Morishita, Tetsuji; Matsunami, Hidetoshi

doi:10.3389/ti.2022.10321

Cited by 8 publications

(11 citation statements)

References 10 publications

(11 reference statements)

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“…Patients treated with MMF before vaccination did not mount sufficient antibody response to BNT162b2 vaccination and might have been rendered unprotected from COVID-19, as suggested by breakthrough infections. We and others have reported poor antibody response after two doses of BNT162b2 mRNA vaccine in SOTs treated with MMF [ 8 , 10 , 12 , 16 ]. We also confirmed previous findings that both MMF administration dose and concentration were inversely related to antibody titers in a linear, dose-response-dependent manner [ 8 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…We and others have reported poor antibody response after two doses of BNT162b2 mRNA vaccine in SOTs treated with MMF [ 8 , 10 , 12 , 16 ]. We also confirmed previous findings that both MMF administration dose and concentration were inversely related to antibody titers in a linear, dose-response-dependent manner [ 8 , 10 ]. Those receiving MMF as maintenance immunosuppression therapy were less likely to develop an antibody response and seroconversion.…”

Section: Discussionmentioning

confidence: 99%

“…Serum was obtained by centrifugation at 1,500× g for 10 min. S receptor-binding domain (RBD) immunoglobulin (Ig)G antibody titers were quantified using the SARS-CoV-2 S-IgG (IC) Assay Reagent assay kit (Fujirebio, Tokyo, Japan) to measure RBD-IgG antibody titers as described previously [ 10 , 15 ]. All procedures were performed according to the instructions from the manufacturer.…”

Section: Methodsmentioning

confidence: 99%

“…Antibody responses after mRNA SARS-CoV-2 vaccination are well-established in the general population [3] , [4] , [5] , [6] , [7] . However, the previous pioneering works revealed blunted antibody responses in solid organ transplant recipients (SOTs) who need continuous immunosuppressive medications to prevent rejection of the transplanted organs [8] , [9] , [10] , [11 , [12] , [13] , [14] . There is a paucity of data in SOTs who use potent immunosuppressants because they have been specifically excluded from SARS-CoV-2 vaccine trials [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Data from recent observational studies suggest that a substantial proportion of patients with solid organ transplant, particularly those undergoing immunosuppression with mycophenolate mofetil (MMF), show attenuated antibody response even after a second or third vaccination [ 8 , 10 , 12 , 15 , 16 ]. We have demonstrated marked attenuation of antibody titers among transplant recipients with MMF in a dose-dependent manner after second doses of a SARS-CoV-2 vaccine [10] . In addition, in a report of a case series, seroconversions were confirmed following withdrawal from MMF in vaccinated transplant recipients without a third vaccination [15] .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Trajectory of the COVID-19 Vaccine Antibody Titers Over Time and the Association of Mycophenolate Mofetil in Solid Organ Transplant Recipients

Sakai

Morishita²,

Suzumura³

et al. 2022

Transplantation Proceedings

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Trajectory of the COVID-19 Vaccine Antibody Titers Over Time and the Association of Mycophenolate Mofetil in Solid Organ Transplant Recipients

Sakai

Morishita²,

Suzumura³

et al. 2022

Transplantation Proceedings

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Antibody titer after administration of mRNA‐based vaccine against severe acute respiratory syndrome coronavirus 2 in liver transplant recipients

Mita

Ohno

Masuda

et al. 2023

Annals of Gastroent Surgery

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IntroductionThe 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.MethodsHerein, 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.ResultsAntibody 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, p < 0.0001). However, a booster vaccine significantly elevated anti‐spike antibodies in LT recipients (p < 0.0001) as well as in healthy controls (p < 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, p = 0.9359). Only 4.0% of vaccinated transplant recipients were positive for anti‐nucleocapsid antibodies.ConclusionLiver 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.

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Meta‐analysis of the immunogenicity of standard and booster SARS‐CoV‐2 vaccination in patients with chronic liver disease and post‐liver transplantation

Wang

Rui

et al. 2023

Portal Hypertension & Cirrhosis

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Aims Patients with liver disease may exhibit higher infection rates and mortality rates from coronavirus disease 2019 (COVID‐19) than healthy individuals, and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is an effective prevention strategy. This meta‐analysis aimed to assess the effectiveness and safety of SARS‐CoV‐2 vaccines in patients with chronic liver disease (CLD) and post‐liver transplantation (LT). Methods The PubMed, Embase, and Cochrane databases were searched. A random‐effects model meta‐analysis was used to determine the seropositivity rates of SARS‐CoV‐2 antibodies, odds ratio (OR) compared with healthy controls (HC), risk ratio (RR) between the booster and standard vaccination regimen, and the rate of adverse reactions (ADR). Results In the standard vaccination regimen analysis, 17 controlled articles were included for effectiveness analysis, and six articles for ADR analysis. The pooled seropositivity rates of SARS‐CoV‐2 antibodies in patients with CLD and post‐LT were 93.3% (95% confidence interval [CI]: 89.0%–97.6%) and 69.1% (95% CI: 63.0%–75.3%), respectively. Both rates were lower than those in HC (p < 0.001). The differences remained significant after sorting by detection interval, vaccine type, antibody type, or CLD type. LT recipients showed much lower seropositivity rates of antibodies than patients with CLD (69.1% vs. 93.3%) or HC (OR: 0.055). The pooled total ADR rate of patients was 24.0% (95% CI: 16.2%–31.8%). In the booster vaccination regimen analysis, 11 prospective studies were enrolled, and the seropositivity rates of antibodies after the booster dose were increased by 27% compared with those of the standard vaccination regimen (RR: 1.27, 95% CI: 1.15–1.41, p < 0.001). Conclusion Patients with CLD and post‐LT can gain protection against COVID‐19 from standard vaccines, demonstrating a potentially weaker immunogenic response than HC. Booster vaccines can compensate for this deficiency. Therefore, patients with CLD and post‐LT should be prioritized for receiving the COVID‐19 booster vaccine.

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Antibody Response After a Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Liver Transplant Recipients

Cited by 8 publications

References 10 publications

The Trajectory of the COVID-19 Vaccine Antibody Titers Over Time and the Association of Mycophenolate Mofetil in Solid Organ Transplant Recipients

The Trajectory of the COVID-19 Vaccine Antibody Titers Over Time and the Association of Mycophenolate Mofetil in Solid Organ Transplant Recipients

Antibody titer after administration of mRNA‐based vaccine against severe acute respiratory syndrome coronavirus 2 in liver transplant recipients

Meta‐analysis of the immunogenicity of standard and booster SARS‐CoV‐2 vaccination in patients with chronic liver disease and post‐liver transplantation

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