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Letter to the editor: Six‐month antibody kinetics and durability in liver transplant recipients after two doses of SARS‐CoV‐2 mRNA vaccination

Year: 2022

Type: letter

Abstract: Six-month antibody kinetics and durability in liver transplant recipients after two doses of SARS-CoV-2 mRNA vaccinationAnti-spike antibody waning after two doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccination among liver transplant (LT) recipients is anticipated, but the peak and decay kinetics might vary by patient phenotype.[1-3] This study evaluated 6-month durability of antibody titers in LT recipients following two-dose homologous mRNA vaccination, focusing on the impact of antimetabolite use.Adult LT-only recipients without reported SARS-CoV-2 infection who had antibody titers measured at 1 month and 3-6 months following homologous mRNA vaccine series (D2) were included from a national observational study (IRB00248540).[1] Seroconversion was assessed using the Roche Elecsys anti-receptorbinding domain or EUROIMMUN anti-S1 assays.Peak and longitudinal anti-S1 trajectories were compared using multilevel mixed-effects linear regression with a patient-level random intercept and an interaction between mycophenolate use and time following D2.Between July 1, 2021, and October 26, 2021, a total of 161 participants received BNT162b2 (47%) or mRNA-1273 (53%) vaccination.Median (interquartile range [IQR]) age was 60 (46-67) years, and most were female (56%).Median (IQR) years since transplant was 6 (3-16).Peri-vaccination immunosuppression regimens included calcineurin inhibitor (87%), antimetabolites (38%), corticosteroids (22%), and mammalian target of rapamycin inhibitor (16%); 20% or 7% received dual (calcineurin inhibitors and steroids) or triple immunosuppression (dual immunosuppression and antimetabolites), respectively.Overall, 136 of 161 (84%) tested seropositive at a median (IQR) of 30 (28-32) days after D2.Of those with available paired titers, 133 of 149 (89%) were seropositive at 3 months, and 49 of 58 (84%) were seropositive at 6 months following D2.Of the 7 seronegative persons with paired titers, 4 (57%) seroconverted to low-level positive titer by 6 months.[4]

Source: Hepatology Communications

DOI: 10.1002/hep4.2027