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Adjustment of Immunosuppressants to Facilitate Anti-COVID-19 Antibody Production after mRNA Vaccination in Liver Transplant Recipients.
Lee, Wei-Chen; Hung, Hao-Chien; Lee, Jin-Chiao; Huang, Chung-Guei; Huang, Po-Wei; Gu, Po-Wen; Wang, Yu-Chao; Cheng, Chih-Hsien; Wu, Tsung-Han; Lee, Chen-Fang; Wu, Ting-Jung; Chou, Hong-Shiue; Chan, Kun-Ming.
  • Lee WC; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Hung HC; Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan.
  • Lee JC; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Huang CG; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Huang PW; Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Gu PW; Department of Medical Biotechnology and Laboratory Science, Chang-Gung University College of Medicine, Taoyuan 33357, Taiwan.
  • Wang YC; Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Cheng CH; Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Wu TH; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Lee CF; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Wu TJ; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Chou HS; Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan.
  • Chan KM; Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan.
Viruses ; 15(3)2023 03 04.
Article in English | MEDLINE | ID: covidwho-2268351
ABSTRACT
Liver transplant recipients are immunocompromised and have low immunogenicity to produce antibodies in anti-COVID-19 vaccination. Whether immunosuppressant adjustment could facilitate anti-COVID-19 antibody production in anti-COVID-19 mRNA vaccination is undetermined. Our patients were informed to temporarily suspend mycophenolate mofetil (MMF) or everolimus (EVR) for 2 weeks during both the 1st and 2nd doses of Moderna mRNA-1273 vaccine. A total of 183 recipients receiving two doses of Moderna mRNA-1273 vaccine were enrolled and grouped into tacrolimus monotherapy (MT, n = 41), and dual therapy with non-adjustment (NA, n = 23), single suspension (SS, n = 19) and double suspension (DS, n = 100) of MMF/EVR in two-dose mRNA vaccination. A total of 155 (84.7%) patients had a humoral response to vaccines in this study. The humoral response rates were 60.9%, 89.5%, 91.0% and 80.5% in NA, SS, DS, and MT group patients, respectively (p = 0.003). Multivariate analysis showed that favorable factors for humoral response were temporary suspension of MMF/EVR and monotherapy, and unfavorable factors were deceased donor liver transplantation, WBC count < 4000/uL, lymphocyte < 20% and tacrolimus trough level ≥ 6.8 ng/mL. In conclusion, temporary two-week suspension of anti-proliferation immunosuppressants could create a window to facilitate antibody production during anti-COVID-19 mRNA vaccination. This concept may be applied to other vaccinations in liver transplant recipients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / COVID-19 Topics: Vaccines Limits: Humans Language: English Year: 2023 Document Type: Article Affiliation country: V15030678

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / COVID-19 Topics: Vaccines Limits: Humans Language: English Year: 2023 Document Type: Article Affiliation country: V15030678