Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults
- PMID: 40309027
- PMCID: PMC12043343
- DOI: 10.1097/TXD.0000000000001787
Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults
Abstract
Background: Adult solid organ transplant recipients (SOTRs) have decreased responsiveness to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination and higher incidence of infection, but there are few data on the serological response in pediatric SOTR. The aim of this study was to determine serological response to SARS-CoV-2 vaccination in pediatric liver (LT) and kidney transplant (KT) recipients and compare it with adult SOTR.
Methods: A European, prospective, multicenter study was performed. Samples were taken at 7 and 32 wk following COVID-19 vaccination and serological endpoints were measured by ELISA.
Results: A total of 42 pediatric (16 post-LT and 26 post-KT) and 117 adult (all post-LT) were included. All pediatric participants and 94% adult participants received mRNA vaccines. Paediatric SOTR patients had significantly higher anti-Spike IgG levels than adult participants at week 7 (114 220.7 [59 285.92-220 058.55] versus 8756.7 [5643.69-13 586.71], P < 0.0001) and week 32 (46 113.2 [10 992.91-193 436.14] versus 8207.0 [3561.20-18 913.43], P = 0.0032). No significant difference in week 7 anti-Spike IgG response was found between pediatric LT and KT (129 434.4 [51 888.64-322 869.69] versus 105 304.5 [39 910.20-277 849.50], P = 0.9854). No differences were seen between children and adults in the rate of decline of anti-Spike IgG between weeks 7 and 32 (P = 0.8000). Male sex and hemolytic-uremic syndrome or postischemic kidney disease were associated with lower anti-Spike IgG levels at week 7 in pediatric SOTR.
Conclusions: Paediatric SOTR demonstrate greater SARS-CoV-2 vaccine responses than comparable adult SOTR patients. These data support efficacy and safety of SARS-CoV-2 vaccination in child SOTR and may alleviate vaccine hesitancy in this patient group.
Copyright © 2025 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
Conflict of interest statement
G.M. owns stock in Hepyx Ltd. M.R.-B. advises GSK and received grants from Gilead. A.S. is on the speakers’ bureau for Abbott. X.V. consults for and received grants from AbbVie. He consults for Eisai. He received grants from Gilead, Dr. Falk Pharma, and Astellas. V.C.P. received grants from Oxford Nanopore Technologies. A.G. owns stock in Tissue Access for Patient Benefit Limited. M.F.D. advises and is on the speakers’ bureau for Kedrion Biopharma. P.T. consults for, is on the speakers’ bureau for, and received grants from Gilead. He consults for and is on the speakers’ bureau for Meso Scale Diagnostic. He is on the speakers’ bureau for and received grants from Intercept. He is on the speakers’ bureau for Meso Scale Diagnostic, AbbVie, Shionogi, SOBI, and Novartis. T.B. advises, is on the speakers’ bureau of, and received grants from Ipsen. He advises and is on the speakers’ bureau for Eisai, Roche, and Bayer. F.P.R. is on the speakers’ bureau for AbbVie and Gilead. M.B. consults for Gilead, Ipsen, Orphalan, Deep-genomic, Alexion, and Chiesi. She received grants from Gilead. V.A. has other interests in Grifols. P.A. is on the speakers’ bureau for and received grants from CSL Behring. He advises BioVie, BioMarin, and Genfit. He is on the speakers’ bureau for Grifols and Kedrion. S.P. consults for Plasma Protein Therapeutics Association and Resolution Therapeutics. He advises Mallinckrodt. He is on the speakers’ bureau for Grifols. U.B. is a consultant for Albireo Pharma, Mirum Pharma, Alexion Pharma, Vivet Pharma and Nestlé. R.J. owns stock in Yaqrit, Hepyx, Cyberliver, and Gigabiome. The other authors declare no conflicts of interest.
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