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. 2025 Apr 29;11(5):e1787.
doi: 10.1097/TXD.0000000000001787. eCollection 2025 May.

Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults

Tobias Laue  1   2 Maria Pilar Ballester  3 Lily Meoli  4 Carl Grabitz  1 Eva Uson  5 Lorenzo D Antiga  6 Valerie McLin  7 Montserrat Pujadas  5 Ângela Carvalho-Gomes  8   9 Ivan Sahuco  8 Ariadna Bono  8 Federico D'Amico  10   11 Raffaela Viganò  12 Elena Diago  13   14   15 Beatriz Tormo Lanseros  13   15 Elvira Inglese  12 Dani Martinez Vazquez  16 Annelotte Broekhoven  17 Marjolein Kikkert  18 Shessy P Torres Morales  18 Sebenzile K Myeni  18 Mar Riveiro-Barciela  15   16   19 Adriana Palom  15   16 Nicola Zeni  20 Alessandra Brocca  20 Annarosa Cussigh  21 Sara Cmet  21 Maria Desamparados Escudero-García  3   22 Matteo Stocco  3 Leonardo Antonio Natola  23 Donatella Ieluzzi  23 Veronica Paon  23 Angelo Sangiovanni  24 Elisa Farina  24 Clara Dibenedetto  24 Yolanda Sánchez-Torrijos  25 Ana Lucena-Varela  25 Eva Román  15   26   27 Elisabet Sánchez  15   26 Rubén Sánchez-Aldehuelo  28 Julia López-Cardona  28 Dhaarica Jeyanesan  4 Alejandro Esquivel Morocho  4 Itzel Canas-Perez  29 Christine Eastgate  29 Simone Di Cola  30 Lucia Lapenna  30 Giacomo Zaccherini  31   32 Deborah Bongiovanni  31 Antonio Riva  33 Rajni Sharma  33 Hio Lam Phoebe Tsou  33 Nicola Harris  33 Paola Zanaga  34   35 Katia Sayaf  34   35 Sabir Hossain  36 Javier Crespo  37   38 Mercedes Robles-Díaz  15   39 Antonio Madejón  40 Helena Degroote  41   42 Marko Korenjak  43 Xavier Verhelst  19   41   44 Javier García-Samaniego  40 Raúl J Andrade  15   39 Paula Iruzubieta  37   38 Gavin Wright  36 Paolo Caraceni  31   32 Manuela Merli  30 Vishal C Patel  4   33 Amir Gander  29 Agustín Albillos  28 Germán Soriano  15   26 Maria Francesca Donato  24 David Sacerdoti  23 Pierluigi Toniutto  21 Maria Buti  14   16 Christophe Duvoux  45 Paolo Antonio Grossi  46 Thomas Berg  47 Wojciech G Polak  48 Massimo Puoti  49 Anna Bosch-Comas  5 Luca S Belli  12 Patrizia Burra  34   35 Francesco Paolo Russo  34   35 Minneke Coenraad  17 José Luis Calleja  13   15 Giovanni Perricone  12 Shilpa Chokshi  33   50 Marina Berenguer  8   9 Joan Clària  5   51 Richard Moreau  5   52   53 Javier Fernández  5   54 Vicente Arroyo  5 Paolo Angeli  19 Cristina Sánchez-Garrido  5 Javier Ampuero  25 Salvatore Piano  19 Emanuele Nicastro  55 Nathalie Rock  7 Debbie Shawcross  56 Lindsey Edwards  57 Frauke Mutschler  1 Anette Melk  1 Gautam Mehta  29   58 Ulrich Baumann  1   59 Rajiv Jalan  5   29   58
Affiliations

Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults

Tobias Laue et al. Transplant Direct. .

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.

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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.

Figures

FIGURE 1.
FIGURE 1.
Study outline. *Second vaccine dose will be given after 6 wk (±1 wk after initial dose according to the recommendations for mRNA vaccines).
FIGURE 2.
FIGURE 2.
Humoral immune responses to COVID-19 vaccination in pediatric and adult patients. Comparison of anti-Spike IgG (A) and anti-RBD IgG (B) levels between pediatric and adult SOTR at weeks 7 and 32 following vaccination. Box plots show geometric mean and interquartile range. The y-axis is scaled logarithmically. RBD, receptor binding domain; SARS-CoV-2, severe acute respiratory syndrome coronavirus type 2; SOTR, solid organ transplant recipients.
FIGURE 3.
FIGURE 3.
Humoral immune responses to COVID-19 vaccination in pediatric liver and kidney transplant patients. Comparison of anti-Spike IgG (A) and anti-RBD IgG (B) levels between pediatric LT and KT recipients. Box plots show geometric mean and interquartile range. The y-axis is scaled logarithmically. KT, kidney transplant; LT, liver transplant; RBD, receptor binding domain; SARS-CoV-2, severe acute respiratory syndrome coronavirus type 2.

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References

    1. Ballester MP, Jalan R, Mehta G. Vaccination in liver diseases and liver transplantation: Recommendations, implications and opportunities in the post-covid era. JHEP Rep. 2023;5:100776. - PMC - PubMed
    1. Mehta G, Riva A, Ballester MP, et al. ; COBALT Consortium. Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant. Hepatol Commun. 2023;7:e0273. - PMC - PubMed
    1. Flaxman S, Whittaker C, Semenova E, et al. . Assessment of COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US. JAMA Netw Open. 2023;6:e2253590. - PMC - PubMed
    1. Zimmermann P, Curtis N. Why does the severity of COVID-19 differ with age?: understanding the mechanisms underlying the age gradient in outcome following SARS-CoV-2 infection. Pediatr Infect Dis J. 2022;41:e36–e45. - PMC - PubMed
    1. Riphagen S, Gomez X, Gonzalez-Martinez C, et al. . Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:1607–1608. - PMC - PubMed

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