Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy
<b>Background</b>: The role of tailored immunosuppression (IS) in the development of the humoral response (HR) to SARS-CoV-2 mRNA-based vaccination in liver transplant (LT) recipients is unknown. <b>Methods</b>: This is a single-centre prospective study of patients who underw...
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/21/6913 |
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| author | Tommaso Maria Manzia Bruno Sensi Luigi Eduardo Conte Leandro Siragusa Roberta Angelico Francesco Frongillo Giuseppe Tisone |
| author_facet | Tommaso Maria Manzia Bruno Sensi Luigi Eduardo Conte Leandro Siragusa Roberta Angelico Francesco Frongillo Giuseppe Tisone |
| author_sort | Tommaso Maria Manzia |
| collection | DOAJ |
| description | <b>Background</b>: The role of tailored immunosuppression (IS) in the development of the humoral response (HR) to SARS-CoV-2 mRNA-based vaccination in liver transplant (LT) recipients is unknown. <b>Methods</b>: This is a single-centre prospective study of patients who underwent LT between January 2015 and December 2021 and who have received three doses of mRNA-based SARS-CoV-2 vaccination. Patients undergoing Tacrolimus-based immunosuppression (TAC-IS) were compared with those undergoing Everolimus-based immunosuppression (EVR-IS). Patients receiving the TAC-EVR combination were divided into two groups based on trough TAC concentrations, i.e., above or below 5 ng/mL. HR (analysed with ECLIA) was assessed at 30 to 135 days after vaccination. The primary outcome was the presence of a positive antibody titre (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>≥</mo></semantics></math></inline-formula>0.8 U/mL). Secondary outcomes were the presence of a highly protective antibody titre (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>≥</mo></semantics></math></inline-formula>142 U/mL), median antibody titre, and incidence of COVID-19. <b>Results</b>: Sixty-one participants were included. Twenty-four (40%) were receiving TAC-IS and thirty-seven (60%) were receiving EVR-IS. At the median follow-up of 116 (range: 89–154) days, there were no significant differences in positive antibody titre (95.8% vs. 94.6%; <i>p</i> = 0.8269), highly-protective antibody titre (83.3% vs. 81.1%; <i>p</i> = 0.8231), median antibody titre (2410 [IQ range 350–2500] vs. 1670 [IQ range 380–2500]; <i>p</i> = 0.9450), and COVID-19 incidence (0% vs. 5.4%; <i>p</i> = 0.5148). High serum creatinine and low estimated glomerular filtration rate were risk factors for a weak or absent HR. <b>Conclusions</b>: Three doses of mRNA-based SARS-CoV-2 vaccination yielded a highly protective HR in LT recipients. The use of TAC or EVR-based IS does not appear to influence HR or antibody titre, while renal disease is a risk factor for a weak or null HR. |
| first_indexed | 2024-03-11T11:26:17Z |
| format | Article |
| id | doaj.art-606852607f6c46fd975cefab2b445963 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T11:26:17Z |
| publishDate | 2023-11-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-606852607f6c46fd975cefab2b4459632023-11-10T15:06:54ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011221691310.3390/jcm12216913Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive TherapyTommaso Maria Manzia0Bruno Sensi1Luigi Eduardo Conte2Leandro Siragusa3Roberta Angelico4Francesco Frongillo5Giuseppe Tisone6Department of Surgical Science, Università degli Studi di Roma “Tor Vergata”, 00133 Rome, ItalyDepartment of Surgical Science, Università degli Studi di Roma “Tor Vergata”, 00133 Rome, ItalyDepartment of Surgical Science, Università degli Studi di Roma “Tor Vergata”, 00133 Rome, ItalyDepartment of Surgical Science, Università degli Studi di Roma “Tor Vergata”, 00133 Rome, ItalyDepartment of Surgical Science, Università degli Studi di Roma “Tor Vergata”, 00133 Rome, ItalyDepartment of Surgery-Transplantation Service, Catholic University of the Sacred Heart, 00168 Rome, ItalyDepartment of Surgery-Transplantation Service, Catholic University of the Sacred Heart, 00168 Rome, Italy<b>Background</b>: The role of tailored immunosuppression (IS) in the development of the humoral response (HR) to SARS-CoV-2 mRNA-based vaccination in liver transplant (LT) recipients is unknown. <b>Methods</b>: This is a single-centre prospective study of patients who underwent LT between January 2015 and December 2021 and who have received three doses of mRNA-based SARS-CoV-2 vaccination. Patients undergoing Tacrolimus-based immunosuppression (TAC-IS) were compared with those undergoing Everolimus-based immunosuppression (EVR-IS). Patients receiving the TAC-EVR combination were divided into two groups based on trough TAC concentrations, i.e., above or below 5 ng/mL. HR (analysed with ECLIA) was assessed at 30 to 135 days after vaccination. The primary outcome was the presence of a positive antibody titre (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>≥</mo></semantics></math></inline-formula>0.8 U/mL). Secondary outcomes were the presence of a highly protective antibody titre (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>≥</mo></semantics></math></inline-formula>142 U/mL), median antibody titre, and incidence of COVID-19. <b>Results</b>: Sixty-one participants were included. Twenty-four (40%) were receiving TAC-IS and thirty-seven (60%) were receiving EVR-IS. At the median follow-up of 116 (range: 89–154) days, there were no significant differences in positive antibody titre (95.8% vs. 94.6%; <i>p</i> = 0.8269), highly-protective antibody titre (83.3% vs. 81.1%; <i>p</i> = 0.8231), median antibody titre (2410 [IQ range 350–2500] vs. 1670 [IQ range 380–2500]; <i>p</i> = 0.9450), and COVID-19 incidence (0% vs. 5.4%; <i>p</i> = 0.5148). High serum creatinine and low estimated glomerular filtration rate were risk factors for a weak or absent HR. <b>Conclusions</b>: Three doses of mRNA-based SARS-CoV-2 vaccination yielded a highly protective HR in LT recipients. The use of TAC or EVR-based IS does not appear to influence HR or antibody titre, while renal disease is a risk factor for a weak or null HR.https://www.mdpi.com/2077-0383/12/21/6913immunosuppressiontailored therapyliver transplantationSARS-CoV-2COVID-19vaccines |
| spellingShingle | Tommaso Maria Manzia Bruno Sensi Luigi Eduardo Conte Leandro Siragusa Roberta Angelico Francesco Frongillo Giuseppe Tisone Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy Journal of Clinical Medicine immunosuppression tailored therapy liver transplantation SARS-CoV-2 COVID-19 vaccines |
| title | Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy |
| title_full | Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy |
| title_fullStr | Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy |
| title_full_unstemmed | Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy |
| title_short | Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy |
| title_sort | evaluation of humoral response following sars cov 2 mrna based vaccination in liver transplant recipients receiving tailored immunosuppressive therapy |
| topic | immunosuppression tailored therapy liver transplantation SARS-CoV-2 COVID-19 vaccines |
| url | https://www.mdpi.com/2077-0383/12/21/6913 |
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