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McCune TR, Bray RA, Baran DA, Toepp AJ, Forte SJ, Gilgannon LT, Williams T, Chen S, Sadr H, Gebel HM, Herre JM. Development of donor specific antibodies after SARS-CoV-2 vaccination in kidney and heart transplant recipients. Transpl Immunol 2022; 75:101722. [PMID: 36152939 PMCID: PMC9492402 DOI: 10.1016/j.trim.2022.101722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022]
Abstract
This study examined the development of new or changes in donor specific antibodies (DSA) mean-fluorescence intensity (MFI) after SARS-CoV-2 vaccination in 100 kidney and 50 heart transplant recipients. The study was performed when the Center for Disease Control and Prevention (CDC) recommended two doses of Pfizer/BioNTech [BNT162b2] and Moderna [mRNA-1273 SARS-CoV-2] vaccine or 1 dose Johnson & Johnson/Janssen [Ad26.COV2·S] vaccines for full vaccination in transplant recipients. A novel assay bead-based platform for detecting antibodies against 4 domains of the SARS-CoV-2 spike protein to determine vaccine response (SA) and one nucleocapsid protein (NC) to determine prior SARS-CoV-2 infection was utilized. These assays were performed on the multiplex, bead-based platform utilized to assay DSA levels. 61/150 patients (40.7%) had successful vaccination. 18 patients had confirmed SARS-CoV-2 infection based on positive NC assay or previous Covid-19 oropharyngeal swab. 138 patients had no DSA prior to vaccination but 3 heart recipients developed new DSA's. Among 12 patients with known DSA prior to vaccination, 4 developed new DSA's or increased MFI. All 7 patients with new or increased DSA had stable graft function without rejection and had no changes in immunosuppression. All 8 patients with stable post vaccine DSA had stable graft function and immunosuppression was not changed. The presence of DSA before vaccination was associated with subsequent development of increased MFI or new DSA's (p = 0.001). There was no association between pre-vaccine DSA and positive vaccine response (NS). There was no association with successful vaccination or prior SARS-CoV-2 infection and DSA changes (NS).
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Affiliation(s)
- Thomas R McCune
- Eastern Virginia Medical School, Division of Nephrology, Norfolk, VA 23501-1980, USA; Sentara Norfolk General Hospital, Kidney/Pancreas Transplant Program, Norfolk, VA 23507, USA; Eastern Virginia Medical School, Department of Internal Medicine, Norfolk, VA 23501-1980, USA.
| | - Robert A Bray
- Emory Univ Hosp, Dept of Pathology Rm F149, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.
| | - David A Baran
- Eastern Virginia Medical School, Division of Cardiology, Norfolk, VA 23501-1980, USA; Sentara Norfolk General Hospital, Advanced Heart Failure and Transplantation, Norfolk, VA 23507-1999, USA; Eastern Virginia Medical School, Department of Internal Medicine, Norfolk, VA 23501-1980, USA
| | - Angela J Toepp
- Sentara Healthcare, Quality Research Institute, Virginia Beach, VA 23462, USA; Enterprise Analytics, Sentara Healthcare, Norfolk, VA 23501, USA.
| | - Steven J Forte
- Eastern Virginia Medical School, School of Medicine, Norfolk, VA 23501-1980, USA.
| | - Lauren T Gilgannon
- Eastern Virginia Medical School, School of Medicine, Norfolk, VA 23501-1980, USA.
| | - Troy Williams
- Enterprise Analytics, Sentara Healthcare, Norfolk, VA 23501, USA.
| | - Shirui Chen
- Eastern Virginia Medical School, Division of Nephrology, Norfolk, VA 23501-1980, USA
| | - Hooman Sadr
- Sentara Norfolk General Hospital, Kidney/Pancreas Transplant Program, Norfolk, VA 23507, USA
| | - Howard M Gebel
- Emory Univ Hosp, Dept of Pathology Rm F149, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.
| | - John M Herre
- Eastern Virginia Medical School, Division of Cardiology, Norfolk, VA 23501-1980, USA; Sentara Norfolk General Hospital, Advanced Heart Failure and Transplantation, Norfolk, VA 23507-1999, USA; Eastern Virginia Medical School, Department of Internal Medicine, Norfolk, VA 23501-1980, USA.
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