Humoral and Cellular Immune Responses After a 3-dose Course of mRNA-1273 COVID-19 Vaccine in Kidney Transplant Recipients: A Prospective Cohort Study. Issue 11 (7th October 2022)

• Record Type: Journal Article
• Authors: Cucchiari, David; Egri, Natalia; Rodriguez-Espinosa, Diana; Montagud-Marrahi, Enrique; Casals-Urquiza, Joaquim; Del Risco-Zevallos, Jimena; Bodro, Marta; Ventura-Aguiar, Pedro; Cofan, Frederic; Cacho, Judit; Molina-Andujar, Alicia; Rovira, Jordi; Banon-Maneus, Elisenda; José Ramirez-Bajo, Maria; Pérez-Olmos, Anna; Garcia-Pascual, Marta; Pascal, Mariona; Vilella, Anna; Trilla, Antoni; Palou, Eduard; Revuelta, Ignacio; Juan, Manel; Campistol, Josep M.; Oppenheimer, Frederic; Moreno, Asunción; Miró, Josep M.; Bayés, Beatriu; Diekmann, Fritz
• Is Part Of: Transplantation direct. Volume 8:Issue 11(2022)
• Page Start: e1389
• Publication Date: 2022-10-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation -- Periodicals; 362.19795
• DOI: 10.1097/TXD.0000000000001389
• Languages: English
• ISSNs: 2373-8731

Abstract

Abstract : Background: In kidney transplant recipients, there is discordance between the development of cellular and humoral response after vaccination against SARS-CoV-2. We sought to determine the interplay between the 2 arms of adaptive immunity in a 3-dose course of mRNA-1273 100 μg vaccine. Methods: Humoral (IgG/IgM) and cellular (N- and S-ELISpot) responses were studied in 117 kidney and 12 kidney-pancreas transplant recipients at the following time points: before the first dose, 14 d after the second dose‚ and before and after the third dose, with a median of 203 and 232 d after the start of the vaccination cycle, respectively. Results: After the second dose, 26.7% of naive cases experienced seroconversion. Before the third dose and in the absence of COVID-19, this percentage increased to 61.9%. After the third dose, seroconversion occurred in 80.0% of patients. Naive patients who had at any time point a detectable positivity for S-ELISpot were 75.2% of the population, whereas patients who maintained S-ELISpot positivity throughout the study were 34.3%. S-ELISpot positivity at 42 d was associated with final seroconversion (odds ratio‚ 3.14; 95% confidence interval‚ 1.10-8.96; P = 0.032). Final IgG titer was significantly higher in patients with constant S-ELISpot positivity ( P < 0.001). Conclusions: A substantial proportion of kidney transplant recipients developed late seroconversion after 2 doses. Cellular immunity was associated with the development of a stronger humoral response.