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. 2024 Jan 19:2:1332616.
doi: 10.3389/frtra.2023.1332616. eCollection 2023.

Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey

Tommaso Di Maira #  1   2   3 , Carmen Vinaixa #  1   2   3 , Manhal Izzy #  4 , Francesco Paolo Russo #  5 , Varvara A Kirchner #  6 , Ashwin Rammohan #  7 , Luca Saverio Belli #  8 , Wojciech Grzegorz Polak #  9 , Thomas Berg #  10 , Marina Berenguer #  1   2   3
Affiliations

Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey

Tommaso Di Maira et al. Front Transplant. .

Abstract

Background: Despite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers.

Methods: A digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers.

Results: Out of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (-3.1, p = 0.002).

Conclusion: COVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population.

Keywords: SARS-CoV-2; liver; policy; side effect; survey; transplant; vaccine; worldwide activity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The number of liver transplant centers included in the survey are graphically represented with a blue scale according to the world health organization regions. European and American Regions had the highest number of included centers (78 and 47, respectively), followed by Western Pacific, South East Asian, and Eastern Mediterranean Regions with 22 (13.1%), 18 (10.7%) and 3 (1.8%) centers, respectively. No centers were included from African Regions.
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