COVID-19 does not impact HLA antibody profile in a series of waitlisted renal transplant candidates

Abstract

HLA antibodies are typically produced after exposure to transplanted tissue, pregnancy, and blood products. Sensitization delays access to transplantation and preclude utilization of donor organs. Infections and vaccinations have also been reported to result in HLA antibody formation. It is not known if patients develop HLA antibodies after infection with SARS-CoV-2. Here we analyzed a series of eighteen patients waiting for kidney transplantation who had symptomatic COVID-19 disease and recovered. None of the patients in this initial series developed de novo HLA antibodies. Notably, there was no increase in preexisting HLA antibodies in four highly sensitized patients with a CPRA >80%. These preliminary data suggest that there may not be a need to repeat HLA antibody testing or perform a physical crossmatch on admission serum before kidney transplant for COVID-19 recovered patients. Data from a large number of patients with different demographics needed.

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

“…Based on a small case-series study of patients with end-stage renal failure awaiting a kidney transplant, there was no development of anti-HLA antibodies as a result from COVID-19 infection [81]. The authors concluded that there may not be a need to repeat HLA antibody testing or perform a physical crossmatch on admission serum before kidney transplant for patients who recovered from COVID-19 [81].…”

Association between SARS-CoV-2 infection and de novo HLA donor specific antibody production in lung transplant recipients: Single-center study

“…Similarly, Masset et al recently reported the incidence of HLA DSA post-SARS-CoV-2 infection was low despite a significant decrease in immunosuppression [22] . No de novo HLA antibodies or an increase in preexisting HLA antibodies was observed post-SARS-CoV-2 infection in a cohort of patients on the kidney transplant waiting list [23] . The long-term effect of COVID-19 pandemic on allograft function and AMR in LTR remain yet to be determined in large prospective studies.…”

Management strategies and outcomes in renal transplant recipients recovering from COVID-19: A retrospective, multicentre, cohort study

“…This observation suggests that sensitization subsequent to COVID-19 infection is a rare event. 30 recipient pairs involved in the study remained at close and dedicated follow-up through in-person/telecommunication for any possible problems. One-year outcomes in transplant recipients and donors in COVID-19 survivors are without any long-term sequelae of COVID-19, and this further adds value to the study contrasting with previous reports.…”