SARS‐CoV‐2 vaccine clinical efficacy in SOT: What we know and our current gaps

Sigler, Rachel; Aslam, Saima

doi:10.1111/tid.13809

Cited by 7 publications

(12 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Factors such as age, sex, comorbidities or immunosuppressive drug type, combination and dosage have been described to impact vaccine response 1,18 . In our study, response to the second dose, or to a third dose for a subset of patients, was not strictly associated with the same factors.…”

Section: Discussionmentioning

confidence: 44%

Torque teno virus viral load predicts SARS‐CoV‐2 vaccine response in kidney transplant recipients

Solis

Benotmane

Gallais

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

Transplant recipients display poor responses to SARS-CoV-2 mRNA vaccines. In this retrospective study, we investigate torque teno virus (TTV) viral load (VL), a ubiquitous virus reflecting global immune response levels, as a predictive factor of vaccine response in kidney transplant recipients (KTR). Four hundred and fifty-nine KTR having received two SARS-CoV-2 mRNA vaccine doses were enrolled, and 241 of them subsequently received a third vaccine dose. Antireceptor-binding domain (RBD) IgG response was assessed after each vaccine dose and TTV VL was measured in pre-vaccine samples. Prevaccine TTV VL > 6.2 log 10 copies (cp)/mL was independently associated with nonresponse to two doses (odds ratio (OR) = 6.17, 95% confidence interval (CI95) = 2.42-15.78) as well as to three doses (OR = 3.62, 95% CI95 = 1.55-8.49). In nonresponders to the second dose, high TTV VL in prevaccine samples or measured before the third dose were equally predictive of lower seroconversion rates and antibody titers. High TTV VL before and during SARS-CoV-2 vaccination schedules are predictive of poor vaccine response in KTR. This biomarker should be further evaluated regarding other vaccine responses.

show abstract

Section: Discussionmentioning

confidence: 44%

Torque teno virus viral load predicts SARS‐CoV‐2 vaccine response in kidney transplant recipients

Solis

Benotmane

Gallais

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

show abstract

“…1 , 2 Availability of vaccination and treatment options with antiviral agents and anti‐spike monoclonal antibodies has led to improved morbidity and mortality among these patients. 3 , 4 , 5 As transplant centers recovered from initial setbacks, important questions arose regarding the safety and timing of transplanting patients who had recovered from COVID‐19 and the feasibility of accepting otherwise suitable organs from COVID‐19 positive (COVID+) donors. 6 , 7 Early experience showed the safety of performing solid organ transplantation (SOT) in patients who had recovered from COVID‐19 as well as successful utilization of organs from donors with remote COVID‐19.…”

Section: Introductionmentioning

confidence: 99%

“…The Coronavirus disease 2019 (COVID‐19) pandemic has had a significant impact on transplantation, including excess mortality in patients on waitlist, higher risk of hospitalization, and death in transplant recipients 1,2 . Availability of vaccination and treatment options with antiviral agents and anti‐spike monoclonal antibodies has led to improved morbidity and mortality among these patients 3–5 . As transplant centers recovered from initial setbacks, important questions arose regarding the safety and timing of transplanting patients who had recovered from COVID‐19 and the feasibility of accepting otherwise suitable organs from COVID‐19 positive (COVID+) donors 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Solid organ transplantation from COVID positive donors in the United States: Analysis of United Network for Organ Sharing database

Dhand

Okumura

Nabors

et al. 2022

Transplant Infectious Dis

View full text Add to dashboard Cite

Background Significant uncertainties remain regarding the utilization of organs for solid organ transplantation (SOT) from donors with coronavirus disease 2019 (COVID‐19). The aim of this study was to assess the trends in utilization of organs from donors with COVID‐19 and their short‐term outcomes. Methods Deceased donors between March 2020 and December 2021 with a positive COVID nucleic acid test from respiratory tract within 14 days of transplantation were analyzed using the de‐identified United Network for Organ Sharing (UNOS) database. Donor and recipient characteristics of COVID‐19 positive (COVID+) organs were compared to COVID‐19 negative (COVID−) organs during this period. We analyzed the trends in the utilization of SOT from COVID+ donors across the United States, donor characteristics, and the quality of donor organ and recipient outcomes (length of hospitalization, rates of organ rejection, delayed graft function, 30‐day graft/patient survival). Results During the study period, 193 COVID+ donors led to the transplantation of 281‐kidneys, 106‐livers, and 36‐hearts in 414 adult recipients. COVID+ patients donated a median of two organs. These donors were younger and had a lower median Kidney Donor Profile Index (0.37 vs. 0.50, p < .001), lower median serum creatinine (0.8 vs. 1.0 mg/dl, p = .003), similar median serum total bilirubin (0.6 mg/dl, p = .46), and similar left ventricular ejection fraction (60%, p = .84) when compared to COVID− donors. Short‐term outcomes, including 30‐day graft/patient survival, were similar in both groups. Conclusions Analysis of short‐term outcomes from the UNOS database indicates that a positive COVID test in an otherwise medically suitable donor should not preclude consideration of non‐lung solid organ transplantation.

show abstract

“…Probably, the identification of these patients unable to develop antibodies may be necessary to better adapt their management. 26 On the one hand, the administration of another additional vaccine dose 27,28 could be to improve the humoral immunization rate in these selected patients. On the other hand, the management of immunosuppressants may be more individualized.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness of SARS-CoV-2 Vaccination in Renal Transplant Recipients. Antibody Levels Impact in Pneumonia and Death

et al. 2022

View full text Add to dashboard Cite

Background. Few studies have described the clinical impact of anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in renal transplant recipients (RTRs) in the context of omicron variant and the third vaccine dose. Antibody titer has been tried to relate to the prediction of outcomes related to SARS-CoV-2, but it results controversially in these populations. Methods. All patients with positive SARS-CoV-2 polymerase chain reaction followed at a RTRs reference center from March 15, 2020, to March 15, 2022, were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by nonantibodies (<20 arbitrary unit [AU]/mL), low (20–100 AU/mL), and high antibody titers (>100 AU/mL) against SARS-CoV-2 spike protein. Outcomes included pneumonia and mortality. We used logistic regression multivariable to assess for confounders. Results. Among 186 RTRs with coronavirus disease 2019, 50.5% (n = 94) were vaccinated versus 49.5% (n = 92) unvaccinated. Of the vaccinated patients, 67.02% developed a high antibody titer (>100 AU/mL) but 14.89% achieved a low antibody titer and 18.08%. Pneumonia-free survival (day 20) was 95% in high antibody titer but 40% in unvaccinated RTRs. Survival in RTRs at day 60 was similar in the unvaccinated group compared with nonantibodies breakthrough cases (82%) but 92% in the low antibody titer group (relative risk, 0.027; 95% confidence interval, 0.002-0.479; P = 0.014). Only patients with >100 AU/mL showed a 100% survival on day 60 postinfection. Conclusions. Vaccinated RTRs who achieve at least a low antibody titer (>20 AU/mL) had better results in terms of pneumonia and mortality than unvaccinated RTRs. Antibody titer >100 AU/mL associate with even better results than patients with lower antibody titers.

show abstract

SARS‐CoV‐2 vaccine clinical efficacy in SOT: What we know and our current gaps

Cited by 7 publications

References 28 publications

Torque teno virus viral load predicts SARS‐CoV‐2 vaccine response in kidney transplant recipients

Torque teno virus viral load predicts SARS‐CoV‐2 vaccine response in kidney transplant recipients

Solid organ transplantation from COVID positive donors in the United States: Analysis of United Network for Organ Sharing database

Clinical Effectiveness of SARS-CoV-2 Vaccination in Renal Transplant Recipients. Antibody Levels Impact in Pneumonia and Death

Contact Info

Product

Resources

About