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Humoral response to SARS-CoV-2 mRNA vaccination in previous non-responder kidney transplant recipients after short-term withdrawal of mycophenolic acid.
Benning, Louise; Morath, Christian; Kühn, Tessa; Bartenschlager, Marie; Kim, Heeyoung; Beimler, Jörg; Buylaert, Mirabel; Nusshag, Christian; Kälble, Florian; Reineke, Marvin; Töllner, Maximilian; Schaier, Matthias; Klein, Katrin; Blank, Antje; Schnitzler, Paul; Zeier, Martin; Süsal, Caner; Bartenschlager, Ralf; Tran, Thuong Hien; Speer, Claudius.
  • Benning L; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Morath C; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Kühn T; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Bartenschlager M; Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany.
  • Kim H; Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany.
  • Beimler J; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Buylaert M; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Nusshag C; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Kälble F; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Reineke M; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Töllner M; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Schaier M; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Klein K; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Blank A; Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.
  • Schnitzler P; German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany.
  • Zeier M; Department of Virology, University of Heidelberg, Heidelberg, Germany.
  • Süsal C; Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
  • Bartenschlager R; Transplant Immunology Research Center of Excellence, Koç University Hospital, Istanbul, Turkey.
  • Tran TH; Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany.
  • Speer C; German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany.
Front Med (Lausanne) ; 9: 958293, 2022.
Article in English | MEDLINE | ID: covidwho-2022776
ABSTRACT
Seroconversion rates after COVID-19 vaccination are significantly lower in kidney transplant recipients compared to healthy cohorts. Adaptive immunization strategies are needed to protect these patients from COVID-19. In this prospective observational cohort study, we enrolled 76 kidney transplant recipients with no seroresponse after at least three COVID-19 vaccinations to receive an additional mRNA-1273 vaccination (full dose, 100 µg). Mycophenolic acid was withdrawn in 43 selected patients 5-7 days prior to vaccination and remained paused for 4 additional weeks after vaccination. SARS-CoV-2-specific antibodies and neutralization of the delta and omicron variants were determined using a live-virus assay 4 weeks after vaccination. In patients with temporary mycophenolic acid withdrawal, donor-specific anti-HLA antibodies and donor-derived cell-free DNA were monitored before withdrawal and at follow-up. SARS-CoV-2 specific antibodies significantly increased in kidney transplant recipients after additional COVID-19 vaccination. The effect was most pronounced in individuals in whom mycophenolic acid was withdrawn during vaccination. Higher SARS-CoV-2 specific antibody titers were associated with better neutralization of SARS-CoV-2 delta and omicron variants. In patients with short-term withdrawal of mycophenolic acid, graft function and donor-derived cell-free DNA remained stable. No acute rejection episode occurred during short-term follow-up. However, resurgence of prior anti-HLA donor-specific antibodies was detected in 7 patients.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Journal: Front Med (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fmed.2022.958293

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines / Variants Language: English Journal: Front Med (Lausanne) Year: 2022 Document Type: Article Affiliation country: Fmed.2022.958293