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. 2023 Dec 13;11(12):1845.
doi: 10.3390/vaccines11121845.

Impact of SARS-CoV-2 Infection on Humoral and Cellular Immunity in a Cohort of Vaccinated Solid Organ Transplant Recipients

Bernardo Ayala-Borges  1 , Miguel Escobedo  2 , Natalia Egri  3 , Sabina Herrera  4   5 , Marta Crespo  6 , Sonia Mirabet  7 , Carlos Arias-Cabrales  6 , Anna Vilella  8 , Eduard Palou  3 , María M Mosquera  9 , Mariona Pascal  3   10 , Jordi Colmenero  2   10 , Marta Farrero  1   10   11 , Marta Bodro  4   5   10   11
Affiliations

Impact of SARS-CoV-2 Infection on Humoral and Cellular Immunity in a Cohort of Vaccinated Solid Organ Transplant Recipients

Bernardo Ayala-Borges et al. Vaccines (Basel). .

Abstract

The aim of the present study was to determine humoral and T-cell responses after four doses of mRNA-1273 vaccine in solid organ transplant (SOT) recipients, and to study predictors of immunogenicity, including the role of previous SARS-CoV-2 infection in immunity. Secondarily, safety was also assessed. Liver, heart, and kidney transplant recipients eligible for SARS-CoV-2 vaccination from three different institutions in Barcelona, Spain were included. IgM/IgG antibodies and T cell ELISpot against the S protein four weeks after receiving four consecutive booster doses of the vaccine were analyzed. One hundred and forty-three SOT recipients were included (41% liver, 38% heart, and 21% kidney). The median time from transplantation to vaccination was 6.6 years (SD 7.4). In total, 93% of the patients developed SARS-CoV-2 IgM/IgG antibodies and 94% S-ELISpot positivity. In total, 97% of recipients developed either humoral or cellular response (100% of liver recipients, 95% of heart recipients, and 88% of kidney recipients). Hypogammaglobulinemia was associated with the absence of SARS-CoV-2 IgG/IgM antibodies and S-ELISpot reactivity after vaccination, whereas past symptomatic SARS-CoV-2 infection was associated with SARS-CoV-2 IgG/IgM antibodies and S-ELISpot reactivity. Local and systemic side effects were generally mild or moderate, and no recipients experienced the development of de novo DSA or graft dysfunction following vaccination.

Keywords: COVID-19; cellular; humoral immunity; immunity; solid organ transplant recipients; vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design showing sample time points, vaccine doses, and number of patients included in each sample time point.
Figure 2
Figure 2
Changes in IgG concentration (A,B) and S-ELISpot (C) before and after different vaccine doses of mRNA-1273 SARS-CoV-2 vaccine. We used the Mann–Whitney test to compare means between groups and the Wilcoxon signed-rank test to compared samples at different time-points within the same group. Bars identify medians. MFI: median fluorescent intensities. BAU: binding antibody units. SFU: spot-forming units.
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