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Erschienen in: General Thoracic and Cardiovascular Surgery 4/2023

26.10.2022 | Original Article

Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection

verfasst von: Yasufumi Goda, Daisuke Nakajima, Satona Tanaka, Yoshito Yamada, Yojiro Yutaka, Kohei Unagami, Mikiko Yoshikawa, Hiroto Egawa, Hiroshi Date

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 4/2023

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Abstract

Objective

Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.

Methods

We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (n = 17) or mRNA-1273 (n = 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.

Results

There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9–10.2) vs 2.8 (1.9–4.0) years, p = 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250–500) vs 1000 (1000–1000) mg/day, p = 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.

Conclusions

The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination.
Literatur
1.
Zurück zum Zitat Saez-Gimenez B, Berastegui C, Barrecheguren M, et al. COVID-19 in lung transplant recipients: a multicenter study. Am J Transplant. 2021;21:1816–24.CrossRefPubMed Saez-Gimenez B, Berastegui C, Barrecheguren M, et al. COVID-19 in lung transplant recipients: a multicenter study. Am J Transplant. 2021;21:1816–24.CrossRefPubMed
2.
Zurück zum Zitat Messika J, Eloy P, Roux A, et al. COVID-19 in lung transplant recipients. Transplantation. 2021;105:177–86.CrossRefPubMed Messika J, Eloy P, Roux A, et al. COVID-19 in lung transplant recipients. Transplantation. 2021;105:177–86.CrossRefPubMed
3.
Zurück zum Zitat Aversa M, Benvenuto L, Anderson M, et al. COVID-19 in lung transplant recipients: a single center case series from New York City. Am J Transplant. 2020;20:3072–80.CrossRefPubMedPubMedCentral Aversa M, Benvenuto L, Anderson M, et al. COVID-19 in lung transplant recipients: a single center case series from New York City. Am J Transplant. 2020;20:3072–80.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Kamp JC, Hinrichs JB, Fuge J, Ewen R, Gottlieb J. COVID-19 in lung transplant recipients-risk prediction and outcomes. PLoS ONE. 2021;16: e0257807.CrossRefPubMedPubMedCentral Kamp JC, Hinrichs JB, Fuge J, Ewen R, Gottlieb J. COVID-19 in lung transplant recipients-risk prediction and outcomes. PLoS ONE. 2021;16: e0257807.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Surgery C. Guidance from the International Society of Heart and Lung Transplantation regarding the SARS CoV-2 pandemic. ISHLT 2020: 2–16. Published online. Surgery C. Guidance from the International Society of Heart and Lung Transplantation regarding the SARS CoV-2 pandemic. ISHLT 2020: 2–16. Published online.
7.
Zurück zum Zitat Uysal EB, Gümüş S, Bektöre B, Bozkurt H, Gözalan A. Evaluation of antibody response after COVID-19 vaccination of healthcare workers. J Med Virol. 2021;94:1060.CrossRefPubMedPubMedCentral Uysal EB, Gümüş S, Bektöre B, Bozkurt H, Gözalan A. Evaluation of antibody response after COVID-19 vaccination of healthcare workers. J Med Virol. 2021;94:1060.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Kaku N, Nishimura F, Shigeishi Y, et al. Performance of anti-SARS-CoV-2 antibody testing in asymptomatic or mild COVID-19 patients: a retrospective study in outbreak on a cruise ship. PLoS ONE. 2021;16: e0257452.CrossRefPubMedPubMedCentral Kaku N, Nishimura F, Shigeishi Y, et al. Performance of anti-SARS-CoV-2 antibody testing in asymptomatic or mild COVID-19 patients: a retrospective study in outbreak on a cruise ship. PLoS ONE. 2021;16: e0257452.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Hallett AM, Greenberg RS, Boyarsky BJ, et al. SARS-CoV-2 messenger RNA vaccine antibody response and reactogenicity in heart and lung transplant recipients. J Heart Lung Transplant. 2021;40:1579–88.CrossRefPubMedPubMedCentral Hallett AM, Greenberg RS, Boyarsky BJ, et al. SARS-CoV-2 messenger RNA vaccine antibody response and reactogenicity in heart and lung transplant recipients. J Heart Lung Transplant. 2021;40:1579–88.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Havlin J, Svorcova M, Dvorackova E, et al. Immunogenicity of BNT162b2 mRNA COVID-19 vaccine and SARS-CoV-2 infection in lung transplant recipients. J Heart Lung Transplant. 2021;40:754–8.CrossRefPubMedPubMedCentral Havlin J, Svorcova M, Dvorackova E, et al. Immunogenicity of BNT162b2 mRNA COVID-19 vaccine and SARS-CoV-2 infection in lung transplant recipients. J Heart Lung Transplant. 2021;40:754–8.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Schramm R, Costard-Jackle A, Rivinius R, et al. Poor humoral and T-cell response to two-dose SARS-CoV-2 messenger RNA vaccine BNT162b2 in cardiothoracic transplant recipients. Clin Res Cardiol. 2021;110:1142–9.CrossRefPubMedPubMedCentral Schramm R, Costard-Jackle A, Rivinius R, et al. Poor humoral and T-cell response to two-dose SARS-CoV-2 messenger RNA vaccine BNT162b2 in cardiothoracic transplant recipients. Clin Res Cardiol. 2021;110:1142–9.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Boyarsky BJ, Werbel WA, Avery RK, et al. Antibody response to 2-Dose SARS-CoV-2 mRNA vaccine series in solid organ transplant recipients. JAMA. 2021;325:2204–6.CrossRefPubMedPubMedCentral Boyarsky BJ, Werbel WA, Avery RK, et al. Antibody response to 2-Dose SARS-CoV-2 mRNA vaccine series in solid organ transplant recipients. JAMA. 2021;325:2204–6.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Kamar N, Abravanel F, Marion O, Couat C, Izopet J, Del Bello A. Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients. N Engl J Med. 2021;385:661–2.CrossRefPubMed Kamar N, Abravanel F, Marion O, Couat C, Izopet J, Del Bello A. Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients. N Engl J Med. 2021;385:661–2.CrossRefPubMed
14.
Zurück zum Zitat Peled Y, Ram E, Lavee J, et al. Third dose of the BNT162b2 vaccine in heart transplant recipients: immunogenicity and clinical experience. J Heart Lung Transplant. 2022;41:148–57.CrossRefPubMed Peled Y, Ram E, Lavee J, et al. Third dose of the BNT162b2 vaccine in heart transplant recipients: immunogenicity and clinical experience. J Heart Lung Transplant. 2022;41:148–57.CrossRefPubMed
15.
Zurück zum Zitat Havlin J, Skotnicova A, Dvorackova E, et al. Impaired humoral response to third dose of BNT162b2 mRNA COVID-19 vaccine despite detectable spike protein-specific t cells in lung transplant recipients. Transplantation. 2021;106:e183.CrossRefPubMedCentral Havlin J, Skotnicova A, Dvorackova E, et al. Impaired humoral response to third dose of BNT162b2 mRNA COVID-19 vaccine despite detectable spike protein-specific t cells in lung transplant recipients. Transplantation. 2021;106:e183.CrossRefPubMedCentral
16.
Zurück zum Zitat Aslam S, Danziger-Isakov L, Mehra MR. COVID-19 vaccination immune paresis in heart and lung transplantation. J Heart Lung Transplant. 2021;40:763–6.CrossRefPubMedPubMedCentral Aslam S, Danziger-Isakov L, Mehra MR. COVID-19 vaccination immune paresis in heart and lung transplantation. J Heart Lung Transplant. 2021;40:763–6.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Kantauskaite M, Müller L, Kolb T, et al. Intensity of mycophenolate mofetil treatment is associated with an impaired immune response to SARS-CoV-2 vaccination in kidney transplant recipients. Am J Transplant. 2022;22:634–9.CrossRefPubMedPubMedCentral Kantauskaite M, Müller L, Kolb T, et al. Intensity of mycophenolate mofetil treatment is associated with an impaired immune response to SARS-CoV-2 vaccination in kidney transplant recipients. Am J Transplant. 2022;22:634–9.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Del Bello A, Marion O, Delas A, Congy-Jolivet N, Colombat M, Kamar N. Acute rejection after anti-SARS-CoV-2 mRNA vaccination in a patient who underwent a kidney transplant. Kidney Int. 2021;100:238–9.CrossRefPubMedPubMedCentral Del Bello A, Marion O, Delas A, Congy-Jolivet N, Colombat M, Kamar N. Acute rejection after anti-SARS-CoV-2 mRNA vaccination in a patient who underwent a kidney transplant. Kidney Int. 2021;100:238–9.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Masset C, Lebot-Bouras S, Branchereau J, Renaudin K, Cantarovich D. Pancreas allograft rejection occurring after ChAdOx1 nCoV-19 vaccine. Diabetes Metab. 2021;48: 101303.CrossRefPubMedPubMedCentral Masset C, Lebot-Bouras S, Branchereau J, Renaudin K, Cantarovich D. Pancreas allograft rejection occurring after ChAdOx1 nCoV-19 vaccine. Diabetes Metab. 2021;48: 101303.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Vyhmeister R, Enestvedt CK, VanSandt M, Schlansky B. Steroid-resistant acute cellular rejection of the liver after severe acute respiratory syndrome coronavirus 2 mRNA vaccination. Liver Transpl. 2021;27:1339–42.CrossRefPubMedPubMedCentral Vyhmeister R, Enestvedt CK, VanSandt M, Schlansky B. Steroid-resistant acute cellular rejection of the liver after severe acute respiratory syndrome coronavirus 2 mRNA vaccination. Liver Transpl. 2021;27:1339–42.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Sahin U, Muik A, Derhovanessian E, et al. COVID-19 vaccine BNT162b1 elicits human antibody and T(H)1 T cell responses. Nature. 2020;586:594–9.CrossRefPubMed Sahin U, Muik A, Derhovanessian E, et al. COVID-19 vaccine BNT162b1 elicits human antibody and T(H)1 T cell responses. Nature. 2020;586:594–9.CrossRefPubMed
22.
Zurück zum Zitat Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324:782–93.CrossRefPubMed Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324:782–93.CrossRefPubMed
23.
Zurück zum Zitat Talotta R. Do COVID-19 RNA-based vaccines put at risk of immune-mediated diseases? In reply to “potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases.” Clin Immunol. 2021;224: 108665.CrossRefPubMedPubMedCentral Talotta R. Do COVID-19 RNA-based vaccines put at risk of immune-mediated diseases? In reply to “potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases.” Clin Immunol. 2021;224: 108665.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Amiya S, Fujimoto J, Matsumoto K, et al. Case report: acute exacerbation of interstitial pneumonia related to messenger RNA COVID-19 vaccination. Int J Infect Dis. 2022;116:255–7.CrossRefPubMedPubMedCentral Amiya S, Fujimoto J, Matsumoto K, et al. Case report: acute exacerbation of interstitial pneumonia related to messenger RNA COVID-19 vaccination. Int J Infect Dis. 2022;116:255–7.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Ghincea A, Ryu C, Herzog EL. An acute exacerbation of idiopathic pulmonary fibrosis after BNT162b2 mRNA COVID-19 vaccination: a case report. Chest. 2022;161:e71–3.CrossRefPubMed Ghincea A, Ryu C, Herzog EL. An acute exacerbation of idiopathic pulmonary fibrosis after BNT162b2 mRNA COVID-19 vaccination: a case report. Chest. 2022;161:e71–3.CrossRefPubMed
26.
Zurück zum Zitat Luppi F, Cerri S, Taddei S, Ferrara G, Cottin V. Acute exacerbation of idiopathic pulmonary fibrosis: a clinical review. Intern Emerg Med. 2015;10:401–11.CrossRefPubMedPubMedCentral Luppi F, Cerri S, Taddei S, Ferrara G, Cottin V. Acute exacerbation of idiopathic pulmonary fibrosis: a clinical review. Intern Emerg Med. 2015;10:401–11.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Frenck RW Jr, Klein NP, Kitchin N, et al. Safety, immunogenicity, and efficacy of the BNT162b2 Covid-19 vaccine in adolescents. N Engl J Med. 2021;385:239–50.CrossRefPubMed Frenck RW Jr, Klein NP, Kitchin N, et al. Safety, immunogenicity, and efficacy of the BNT162b2 Covid-19 vaccine in adolescents. N Engl J Med. 2021;385:239–50.CrossRefPubMed
28.
Zurück zum Zitat Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384:403–16.CrossRefPubMed Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384:403–16.CrossRefPubMed
29.
Zurück zum Zitat Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383:2603–15.CrossRefPubMed Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383:2603–15.CrossRefPubMed
Metadaten
Titel
Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection
verfasst von
Yasufumi Goda
Daisuke Nakajima
Satona Tanaka
Yoshito Yamada
Yojiro Yutaka
Kohei Unagami
Mikiko Yoshikawa
Hiroto Egawa
Hiroshi Date
Publikationsdatum
26.10.2022
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 4/2023
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-022-01887-3

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