SARS-CoV-2 Vaccination-Induced Immunogenicity in Heart Transplant Recipients

TY - JOUR

T1 - SARS-CoV-2 Vaccination-Induced Immunogenicity in Heart Transplant Recipients

AU - Memenga, Felix

AU - Kueppers, Simon Thomas

AU - Borof, Katrin

AU - Kirchhof, Paulus

AU - Duengelhoef, Paul Maria

AU - Barten, Markus Johannes

AU - Lütgehetmann, Marc

AU - Berisha, Filip

AU - Fluschnik, Nina

AU - Becher, Peter Moritz

AU - Kondziella, Christoph

AU - Bernhardt, Alexander M

AU - Reichenspurner, Hermann

AU - Blankenberg, Stefan

AU - Magnussen, Christina

AU - Rybczynski, Meike

N1 - Copyright © 2023 Memenga, Kueppers, Borof, Kirchhof, Duengelhoef, Barten, Lütgehetmann, Berisha, Fluschnik, Becher, Kondziella, Bernhardt, Reichenspurner, Blankenberg, Magnussen and Rybczynski.

PY - 2023/2/6

Y1 - 2023/2/6

N2 - Among heart transplant (HT) recipients, a reduced immunological response to SARS-CoV-2 vaccination has been reported. We aimed to assess the humoral and T-cell response to SARS-CoV-2 vaccination in HT recipients to understand determinants of immunogenicity. HT recipients were prospectively enrolled from January 2021 until March 2022. Anti-SARS-CoV-2-Spike IgG levels were quantified after two and three doses of a SARS-CoV-2 vaccine (BNT162b2, mRNA1273, or AZD1222). Spike-specific T-cell responses were assessed using flow cytometry. Ninety-one patients were included in the study (69% male, median age 55 years, median time from HT to first vaccination 6.1 years). Seroconversion rates were 34% after two and 63% after three doses. Older patient age (p = 0.003) and shorter time since HT (p = 0.001) were associated with lower antibody concentrations after three vaccinations. There were no associations between vaccine types or immunosuppressive regimens and humoral response, except for prednisolone, which was predictive of a reduced response after two (p = 0.001), but not after three doses (p = 0.434). A T-cell response was observed in 50% after two and in 74% after three doses. Despite three vaccine doses, a large proportion of HT recipients exhibits a reduced immune response. Additional strategies are desirable to improve vaccine immunogenicity in this vulnerable group of patients.

AB - Among heart transplant (HT) recipients, a reduced immunological response to SARS-CoV-2 vaccination has been reported. We aimed to assess the humoral and T-cell response to SARS-CoV-2 vaccination in HT recipients to understand determinants of immunogenicity. HT recipients were prospectively enrolled from January 2021 until March 2022. Anti-SARS-CoV-2-Spike IgG levels were quantified after two and three doses of a SARS-CoV-2 vaccine (BNT162b2, mRNA1273, or AZD1222). Spike-specific T-cell responses were assessed using flow cytometry. Ninety-one patients were included in the study (69% male, median age 55 years, median time from HT to first vaccination 6.1 years). Seroconversion rates were 34% after two and 63% after three doses. Older patient age (p = 0.003) and shorter time since HT (p = 0.001) were associated with lower antibody concentrations after three vaccinations. There were no associations between vaccine types or immunosuppressive regimens and humoral response, except for prednisolone, which was predictive of a reduced response after two (p = 0.001), but not after three doses (p = 0.434). A T-cell response was observed in 50% after two and in 74% after three doses. Despite three vaccine doses, a large proportion of HT recipients exhibits a reduced immune response. Additional strategies are desirable to improve vaccine immunogenicity in this vulnerable group of patients.

KW - Humans

KW - Male

KW - Middle Aged

KW - Female

KW - COVID-19 Vaccines

KW - BNT162 Vaccine

KW - COVID-19

KW - ChAdOx1 nCoV-19

KW - SARS-CoV-2

KW - Vaccination

KW - Antibodies, Viral

KW - Immunoglobulin G

KW - Heart Transplantation

KW - Transplant Recipients

U2 - 10.3389/ti.2023.10883

DO - 10.3389/ti.2023.10883

M3 - SCORING: Journal article

C2 - 36814697

VL - 36

SP - 10883

JO - TRANSPL INT

JF - TRANSPL INT

SN - 0934-0874

ER -