Navigating Through the Complications of Chronic Immunosuppression in Transplant Patients

Amaeshi, Lemchukwu Chukwunonye

doi:10.7326/aimcc.2022.0940

Cited by 1 publication

(1 citation statement)

References 5 publications

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“…Despite excellent long-term median transplant survival rates-more than 14 years for both kidney and liver [3]-solid organ transplantation comes at a price mostly driven by Viruses 2024, 16, 1 2 of 11 the need for long-term immunosuppression. Complications thereof include predisposition to infections, malignancies, and cardiovascular diseases [4].…”

Section: Introductionmentioning

confidence: 99%

B and T Cell Responses to SARS-CoV-2 Vaccination in Kidney and Liver Transplant Recipients with and without Previous COVID-19

Watschinger,

Stampfel,

Zollner

et al. 2023

Viruses

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(1) Background: Vulnerable populations including transplant recipients are jeopardised by COVID-19. Herein, we report on B and T cell responses among liver and kidney organ recipients at our centre. (2) Methods: 23 liver and 45 kidney (14 thereof combined kidney/pancreas) transplanted patients were vaccinated with two doses of BNT162b2 followed by a booster dose of mRNA-1273 in 28 non-responders 4 months thereafter. Anti-SARS-CoV-2-Ig was measured by specific ELISA and virus neutralisation assay; T cell responses were measured by a spike protein-specific IFN-γ release assay. (3) Results: Compared to controls, B and T cell responses were weak in transplant recipients, particularly in those without prior exposure to SARS-CoV-2. Within this group, only 15% after the first and 58.3% after the second vaccination achieved seroconversion. A total of 14 out of 28 vaccination non-responders achieved a seroconversion after a third dose. Vaccination side effects were more frequent in healthy controls. The use of mycophenolate was associated with reduced anti-SARS-CoV-2-Ig production. (4) Conclusions: Our data confirm that vaccination responses are insufficient after standard vaccination in liver and kidney transplant recipients and are affected to a variable degree by specific immunosuppressants, particularly mycophenolate. Monitoring vaccination success and re-vaccinating those who are unresponsive seems prudent to achieve sufficient titres. Overall, prospective large-scale, multinational, multicentre studies or high-quality meta-analyses will be needed to generate personalised vaccination strategies in order to achieve protective immunity in high-risk, hard-to-immunize populations.

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Section: Introductionmentioning

confidence: 99%