Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;20(7):1534-1541.e4.
doi: 10.1016/j.cgh.2022.01.012. Epub 2022 Jan 20.

Humoral Response to 2-dose BNT162b2 mRNA COVID-19 Vaccination in Liver Transplant Recipients

Maria Guarino  1 , Ilaria Esposito  2 , Giuseppe Portella  3 , Valentina Cossiga  4 , Ilaria Loperto  5 , Raffaella Tortora  2 , Michele Cennamo  3 , Mario Capasso  4 , Daniela Terracciano  3 , Alfonso Galeota Lanza  2 , Sarah Di Somma  3 , Francesco Paolo Picciotto  2 , Filomena Morisco  4 ; UniNa Collaborating Group
Collaborators, Affiliations

Humoral Response to 2-dose BNT162b2 mRNA COVID-19 Vaccination in Liver Transplant Recipients

Maria Guarino et al. Clin Gastroenterol Hepatol. 2022 Jul.

Abstract

Background & aims: In the context of the Italian severe acute respiratory syndrome coronavirus 2 vaccination program, liver transplant (LT) recipients were prioritized for vaccine administration, although the lower response to vaccines is a well-known problem in this population. We aimed to evaluate immunogenicity of BNT162b2 mRNA vaccine in LT recipients and healthy controls and to identify factors associated with negative response to vaccine.

Methods: In a cohort of adult patients with LT, we prospectively evaluated the humoral response (with anti-Spike protein IgG-LIAISON SARS-CoV-2 S1/S2-IgG chemiluminescent assay) at 1 and 3 months after 2-dose vaccination. A group of 307 vaccinated health care workers, matched by age and sex, served as controls.

Results: Overall, 492 LT patients were enrolled (75.41% male; median age, 64.85 years). Detectable antibodies were observed in the 75% of patients, with a median value of 73.9 AU/mL after 3 months from 2-dose vaccination. At multivariable analysis, older age (>40 years; P = .016), shorter time from liver transplantation (<5 years; P = .004), and immunosuppression with antimetabolites (P = .029) were significantly associated with non-response to vaccination. Moreover, the LT recipients showed antibody titers statistically lower than the control group (103 vs 261 AU/mL; P < .0001). Finally, in both controls and LT patients, we found a trend of inverse correlation between age and antibody titers (correlation coefficients: -0.2023 and -0.2345, respectively).

Conclusions: Three months after vaccination, LT recipients showed humoral response in 75% of cases. Older age, shorter time from transplantation, and use of antimetabolites were factors associated with non-response to vaccination, and LT recipients at risk of non-response to vaccination needed to be kept under close monitoring.

Keywords: COVID-19; Immunosuppression; Liver Transplantation; SARS-CoV-2 Vaccination.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Humoral response to 2-dose BNT162b2 vaccine after 1 and 3 months in LT patients and health care workers (controls).
Figure 3
Figure 3
Scatterplot correlation between age and antibody titers in LT recipients (right panel) and health care workers as controls (left panel).
See this image and copyright information in PMC

References

    1. Mulligan M.J., Lyke K.E., Kitchin N., et al. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature. 2020;586:589–593. - PubMed
    1. Polack F.P., Thomas S.J., Kitchin N., et al. C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. New Engl J Med. 2020;383:2603–2615. - PMC - PubMed
    1. Pereira M.R., Mohan S., Cohen D.J., et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter. Am J Transplant. 2020;20:1800–1808. - PMC - PubMed
    1. Eckerle I., Rosenberger K.D., Zwahlen M., et al. Serologic vaccination response after solid organ transplantation: a systematic review. PLoS One. 2013;8 - PMC - PubMed
    1. Cornberg M., Buti M., Eberhardt C.S., et al. EASL position paper on the use of COVID-19 vaccines in patients with chronic liver diseases, hepatobiliary cancer and liver transplant recipients. J Hepatol. 2021;74:944–951. - PMC - PubMed