The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients
IntroductionThe study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave...
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| Format: | Article |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1203854/full |
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| author | Maria Rendina Michele Barone Chiara Lillo Silvia Trapani Lucia Masiero Paolo Trerotoli Francesca Puoti Luigi Giovanni Lupo Francesco Tandoi Salvatore Agnes Antonio Grieco Enzo Andorno Simona Marenco Edoardo Giovanni Giannini Umberto Baccarani Pierluigi Toniutto Amedeo Carraro Antonio Colecchia Matteo Cescon Maria Cristina Morelli Umberto Cillo Patrizia Burra Paolo Angeli Michele Colledan Stefano Fagiuoli Stefano Fagiuoli Luciano De Carlis Luca Belli Paolo De Simone Paola Carrai Fabrizio Di Benedetto Nicola De Maria Giuseppe Maria Ettorre Valerio Giannelli Salvatore Gruttadauria Salvatore Gruttadauria Riccardo Volpes Sveva Corsale Vincenzo Mazzaferro Vincenzo Mazzaferro Sherrie Bhoori Renato Romagnoli Silvia Martini Giorgio Rossi Lucio Caccamo Maria Francesca Donato Massimo Rossi Stefano Ginanni Corradini Marco Spada Giuseppe Maggiore Giuseppe Tisone Ilaria Lenci Giovanni Vennarecci Raffaella Tortora Marco Vivarelli Gianluca Svegliati Baroni Fausto Zamboni Laura Mameli Silvio Tafuri Simona Simone Loreto Gesualdo Massimo Cardillo Alfredo Di Leo |
| author_facet | Maria Rendina Michele Barone Chiara Lillo Silvia Trapani Lucia Masiero Paolo Trerotoli Francesca Puoti Luigi Giovanni Lupo Francesco Tandoi Salvatore Agnes Antonio Grieco Enzo Andorno Simona Marenco Edoardo Giovanni Giannini Umberto Baccarani Pierluigi Toniutto Amedeo Carraro Antonio Colecchia Matteo Cescon Maria Cristina Morelli Umberto Cillo Patrizia Burra Paolo Angeli Michele Colledan Stefano Fagiuoli Stefano Fagiuoli Luciano De Carlis Luca Belli Paolo De Simone Paola Carrai Fabrizio Di Benedetto Nicola De Maria Giuseppe Maria Ettorre Valerio Giannelli Salvatore Gruttadauria Salvatore Gruttadauria Riccardo Volpes Sveva Corsale Vincenzo Mazzaferro Vincenzo Mazzaferro Sherrie Bhoori Renato Romagnoli Silvia Martini Giorgio Rossi Lucio Caccamo Maria Francesca Donato Massimo Rossi Stefano Ginanni Corradini Marco Spada Giuseppe Maggiore Giuseppe Tisone Ilaria Lenci Giovanni Vennarecci Raffaella Tortora Marco Vivarelli Gianluca Svegliati Baroni Fausto Zamboni Laura Mameli Silvio Tafuri Simona Simone Loreto Gesualdo Massimo Cardillo Alfredo Di Leo |
| author_sort | Maria Rendina |
| collection | DOAJ |
| description | IntroductionThe study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators.MethodsCase collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate.ResultsAmong the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP.DiscussionAccording to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different from NL-SOTRs, probably related to the ability of the grafted liver to induce immunotolerance. |
| first_indexed | 2024-03-13T01:26:35Z |
| format | Article |
| id | doaj.art-c4d3b44507e04451af16bce55382dafb |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-13T01:26:35Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-c4d3b44507e04451af16bce55382dafb2023-07-04T14:28:52ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-07-011410.3389/fimmu.2023.12038541203854The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipientsMaria Rendina0Michele Barone1Chiara Lillo2Silvia Trapani3Lucia Masiero4Paolo Trerotoli5Francesca Puoti6Luigi Giovanni Lupo7Francesco Tandoi8Salvatore Agnes9Antonio Grieco10Enzo Andorno11Simona Marenco12Edoardo Giovanni Giannini13Umberto Baccarani14Pierluigi Toniutto15Amedeo Carraro16Antonio Colecchia17Matteo Cescon18Maria Cristina Morelli19Umberto Cillo20Patrizia Burra21Paolo Angeli22Michele Colledan23Stefano Fagiuoli24Stefano Fagiuoli25Luciano De Carlis26Luca Belli27Paolo De Simone28Paola Carrai29Fabrizio Di Benedetto30Nicola De Maria31Giuseppe Maria Ettorre32Valerio Giannelli33Salvatore Gruttadauria34Salvatore Gruttadauria35Riccardo Volpes36Sveva Corsale37Vincenzo Mazzaferro38Vincenzo Mazzaferro39Sherrie Bhoori40Renato Romagnoli41Silvia Martini42Giorgio Rossi43Lucio Caccamo44Maria Francesca Donato45Massimo Rossi46Stefano Ginanni Corradini47Marco Spada48Giuseppe Maggiore49Giuseppe Tisone50Ilaria Lenci51Giovanni Vennarecci52Raffaella Tortora53Marco Vivarelli54Gianluca Svegliati Baroni55Fausto Zamboni56Laura Mameli57Silvio Tafuri58Simona Simone59Loreto Gesualdo60Massimo Cardillo61Alfredo Di Leo62Gastroenterology Unit, University Hospital Policlinico of Bari, Bari, ItalyGastroenterology Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari Aldo Moro, Bari, ItalyGastroenterology Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari Aldo Moro, Bari, ItalyItalian National Transplant Center, National Institute of Health, Rome, ItalyItalian National Transplant Center, National Institute of Health, Rome, ItalySection of Statistics, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, ItalyItalian National Transplant Center, National Institute of Health, Rome, ItalyGeneral Surgery and Liver Transplantation Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari, Bari, ItalyGeneral Surgery and Liver Transplantation Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari, Bari, ItalyU.O.C. Chirurgia Generale e Trapianti di Organo, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, ItalyU.O.C. Medicina Interna e del Trapianto di Fegato, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma, ItalyChirurgia dei Trapianti di Fegato, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, ItalyGastroenterology Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, ItalyGastroenterology Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy0Centro Trapianto di Fegato, A.O.U.I. Udine, Università degli Studi di Udine, Udine, Italy1U.S.D. Epatologia e Trapianto di Fegato, A.O.U.I. Udine, Università degli Studi di Udine, Udine, Italy2U.S.D. Trapianti Epatici A.O.U.I. Verona, Verona, Italy3Gastroenterology Unit, Department of Medical Specialties, University Hospital of Modena, Modena, Italy4Chirurgia Epatobiliare e dei Trapianti, IRCCS, A.O.U. di Bologna, University of Bologna, Bologna, Italy5Internal Medicine Unit for the Treatment of Severe Organ Failure, IRCCS, A.O.U. di Bologna, Bologna, Italy6Hepatobiliary Surgery and Liver Transplantation, University-Teaching Hospital of Padova, Padova, Italy7Multivisceral Transplant Unit, University-Teaching Hospital of Padova, Padova, Italy8Unit of Internal Medicine and Hepatology (UIMH), University-Teaching Hospital of Padova, Padova, Italy9U.O.C. Chirurgia Generale III, Centro Trapianti Fegato, A.S.S.T. Ospedale Papa Giovanni XXIII, Bergamo, Italy0Gastroenterology Hepatology and Transplantation Unit, A.S.S.T. Ospedale Papa Giovanni XXIII, Bergamo, Italy1Gastroenterologia, Department of Medicine University of Milan Bicocca, Milano, Italy2Chirurgia Generale dei Trapianti, Azienda Ospedaliera Niguarda Ca’Granda, University of Milano-Bicocca, Milano, Italy3U.O.C. Epatologia e Gastroenterologia, Azienda Ospedaliera Niguarda Ca’Granda, Milano, Italy4U.O.C. Chirurgia Epatica e Trapianti di Fegato, A.O.U. Pisana, University of Pisa, Pisa, Italy5U.O. Chirurgia Epatica e del Trapianto di Fegato, A.O.U. Pisana, Pisa, Italy6U.O.C. di Chirurgia Oncologica Epatobiliopancreatica e Chirurgia dei Trapianti di Fegato, Azienda Ospedaliera Policlinico, Università di Modena, Modena, Italy7U.O.C. Chirurgia Generale e Trapianti, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy8Hepatology Unit, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy8Hepatology Unit, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy9IRCCS-ISMETT-UPMCI, Palermo, Italy0University of Catania, Catania, Italy1Unità di Gastroenterologia ed Epatologia, IRCCS-ISMETT-UPMCI, Palermo, Italy1Unità di Gastroenterologia ed Epatologia, IRCCS-ISMETT-UPMCI, Palermo, Italy2Hepato-pancreatic-biliary surgery and Liver transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy3Department of Oncology, University of Milan, Milan, Italy2Hepato-pancreatic-biliary surgery and Liver transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy4Chirurgia Generale 2, Centro Trapianto Fegato A.O.U Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy5Gastroenteroly Unit, A.O.U Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy6Division of General and Liver Transplant Surgery, Ospedale Maggiore Policlinico, Milano, Italy6Division of General and Liver Transplant Surgery, Ospedale Maggiore Policlinico, Milano, Italy7Division of Gastroenterology and Hepatology, Ospedale Maggiore Policlinico, Milano, Italy8U.O.C. di Chirurgia Generale e Trapianti di Organo, Policlinico Umberto I, Sapienza Università di Roma, Rome, Italy9Gastroenterology Unit, Policlinico Umberto I, Sapienza Università di Roma, Rome, Italy0Division of Hepatobiliopancreatic Surgery, Liver and Kidney Transplantation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy1Hepatogastroenterology, Digestive Endoscopy, Nutrition and Liver Transplantation Unit, Gesù Children’s Hospital, IRCCS, Rome, Italy2Liver Transplant Unit, A.O.U. Policlinico Tor Vergata, University of Tor Vergata Rome, Rome, Italy3Hepatology Unit, A.O.U. Policlinico Tor Vergata, University of Tor Vergata Rome, Rome, Italy4Hepatobiliary and Liver Tranplantation Surgery, A.O.R.N. “A. CARDARELLI”, Naples, Italy5Liver Unit, A.O.R.N. “A. CARDARELLI”, Naples, Italy6Chirurgia Epatobiliare, Pancreatica e dei Trapianti, A.O.U., Ospedali Riuniti, Ancona, Italy7Gastroenterology Unit, A.O.U., Ospedali Riuniti, Ancona, Italy8General and Hepatic Transplantation Surgery Unit, AO.B. G. Brotzu, Cagliari, Italy8General and Hepatic Transplantation Surgery Unit, AO.B. G. Brotzu, Cagliari, Italy9Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy0Dialysis and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari Aldo Moro, Bari, Italy0Dialysis and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari Aldo Moro, Bari, ItalyItalian National Transplant Center, National Institute of Health, Rome, ItalyGastroenterology Unit, Department of Precision and Regenerative Medicine - Ionian Area-, University of Bari Aldo Moro, Bari, ItalyIntroductionThe study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators.MethodsCase collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate.ResultsAmong the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP.DiscussionAccording to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different from NL-SOTRs, probably related to the ability of the grafted liver to induce immunotolerance.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1203854/fullCOVID-19liver transplantationsolid organ transplantimmunotolerancemicrochimerism |
| spellingShingle | Maria Rendina Michele Barone Chiara Lillo Silvia Trapani Lucia Masiero Paolo Trerotoli Francesca Puoti Luigi Giovanni Lupo Francesco Tandoi Salvatore Agnes Antonio Grieco Enzo Andorno Simona Marenco Edoardo Giovanni Giannini Umberto Baccarani Pierluigi Toniutto Amedeo Carraro Antonio Colecchia Matteo Cescon Maria Cristina Morelli Umberto Cillo Patrizia Burra Paolo Angeli Michele Colledan Stefano Fagiuoli Stefano Fagiuoli Luciano De Carlis Luca Belli Paolo De Simone Paola Carrai Fabrizio Di Benedetto Nicola De Maria Giuseppe Maria Ettorre Valerio Giannelli Salvatore Gruttadauria Salvatore Gruttadauria Riccardo Volpes Sveva Corsale Vincenzo Mazzaferro Vincenzo Mazzaferro Sherrie Bhoori Renato Romagnoli Silvia Martini Giorgio Rossi Lucio Caccamo Maria Francesca Donato Massimo Rossi Stefano Ginanni Corradini Marco Spada Giuseppe Maggiore Giuseppe Tisone Ilaria Lenci Giovanni Vennarecci Raffaella Tortora Marco Vivarelli Gianluca Svegliati Baroni Fausto Zamboni Laura Mameli Silvio Tafuri Simona Simone Loreto Gesualdo Massimo Cardillo Alfredo Di Leo The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients Frontiers in Immunology COVID-19 liver transplantation solid organ transplant immunotolerance microchimerism |
| title | The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients |
| title_full | The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients |
| title_fullStr | The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients |
| title_full_unstemmed | The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients |
| title_short | The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients |
| title_sort | italian data on sars cov 2 infection in transplanted patients support an organ specific immune response in liver recipients |
| topic | COVID-19 liver transplantation solid organ transplant immunotolerance microchimerism |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1203854/full |
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