Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection
Objective Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown. Methods We performed a...
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| Veröffentlicht in: | General thoracic and cardiovascular surgery 2023-04, Vol.71 (4), p.251-257 |
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| creator | Goda, Yasufumi Nakajima, Daisuke Tanaka, Satona Yamada, Yoshito Yutaka, Yojiro Unagami, Kohei Yoshikawa, Mikiko Egawa, Hiroto Date, Hiroshi |
| description | Objective
Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.
Methods
We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (
n
= 17) or mRNA-1273 (
n
= 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.
Results
There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9–10.2) vs 2.8 (1.9–4.0) years,
p
= 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250–500) vs 1000 (1000–1000) mg/day,
p
= 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.
Conclusions
The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination. |
| doi_str_mv | 10.1007/s11748-022-01887-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2729521142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2729521142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-aca5bcf944ba396eb9975a809b404837c4e84d1b9dc167b40692b03b7a3823d33</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EoqXwB1ggS2zYGPxKbLMbjcpDqkBqC1vLdm4GjzJOaieV5t_X0ylFYtGVr-zvnnt8D0JvGf3IKFWfCmNKakI5J5RprYh4hk6ZbgVpFRPPH2vanKBXpWwpbVrNmpfoRLRcG9bqU3Rz3vcxuLDHLnW4uB7mPR57PP8BfLW6vCLr8TfheHf5Y4VvXQgxAY4JD0va4Dm7VKbBpRlnCHGKkObyGTs8jaVEP0Al4mYD-SCYYQthjmN6jV70bijw5uE8Q7--nF-vv5GLn1-_r1cXJEgpZuKCa3zojZTeCdOCN0Y1TlPjJZVaqCBBy4550wXWqnrZGu6p8MoJzUUnxBn6cNSd8nizQJntLpYAQ_UL41IsV9w0nDHJK_r-P3Q7LjlVd5YbppXkdW2V4kcq5Pq_DL2dcty5vLeM2kMg9hiIrYHY-0DswcW7B-nF76B7bPmbQAXEESj1KdVl_Zv9hOwdef2Uyg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2918742815</pqid></control><display><type>article</type><title>Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><source>ProQuest Central</source><creator>Goda, Yasufumi ; Nakajima, Daisuke ; Tanaka, Satona ; Yamada, Yoshito ; Yutaka, Yojiro ; Unagami, Kohei ; Yoshikawa, Mikiko ; Egawa, Hiroto ; Date, Hiroshi</creator><creatorcontrib>Goda, Yasufumi ; Nakajima, Daisuke ; Tanaka, Satona ; Yamada, Yoshito ; Yutaka, Yojiro ; Unagami, Kohei ; Yoshikawa, Mikiko ; Egawa, Hiroto ; Date, Hiroshi</creatorcontrib><description>Objective
Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.
Methods
We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (
n
= 17) or mRNA-1273 (
n
= 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.
Results
There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9–10.2) vs 2.8 (1.9–4.0) years,
p
= 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250–500) vs 1000 (1000–1000) mg/day,
p
= 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.
Conclusions
The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination.</description><identifier>ISSN: 1863-6705</identifier><identifier>EISSN: 1863-6713</identifier><identifier>DOI: 10.1007/s11748-022-01887-3</identifier><identifier>PMID: 36289168</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Antibodies ; Antigens ; BNT162 Vaccine ; Body mass index ; Brain death ; Cardiac Surgery ; Cardiology ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; COVID-19 vaccines ; COVID-19 Vaccines - adverse effects ; Drug dosages ; Dyspnea ; Humans ; Immunoglobulin G ; Lavage ; Lung ; Lung transplants ; Medicine ; Medicine & Public Health ; mRNA Vaccines ; Original Article ; Patients ; Prospective Studies ; Pulmonary fibrosis ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Steroids ; Surgical Oncology ; Thoracic Surgery ; Transplant Recipients</subject><ispartof>General thoracic and cardiovascular surgery, 2023-04, Vol.71 (4), p.251-257</ispartof><rights>The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-aca5bcf944ba396eb9975a809b404837c4e84d1b9dc167b40692b03b7a3823d33</citedby><cites>FETCH-LOGICAL-c443t-aca5bcf944ba396eb9975a809b404837c4e84d1b9dc167b40692b03b7a3823d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11748-022-01887-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918742815?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,41464,42533,43781,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36289168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goda, Yasufumi</creatorcontrib><creatorcontrib>Nakajima, Daisuke</creatorcontrib><creatorcontrib>Tanaka, Satona</creatorcontrib><creatorcontrib>Yamada, Yoshito</creatorcontrib><creatorcontrib>Yutaka, Yojiro</creatorcontrib><creatorcontrib>Unagami, Kohei</creatorcontrib><creatorcontrib>Yoshikawa, Mikiko</creatorcontrib><creatorcontrib>Egawa, Hiroto</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><title>Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection</title><title>General thoracic and cardiovascular surgery</title><addtitle>Gen Thorac Cardiovasc Surg</addtitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><description>Objective
Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.
Methods
We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (
n
= 17) or mRNA-1273 (
n
= 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.
Results
There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9–10.2) vs 2.8 (1.9–4.0) years,
p
= 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250–500) vs 1000 (1000–1000) mg/day,
p
= 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.
Conclusions
The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination.</description><subject>Antibodies</subject><subject>Antigens</subject><subject>BNT162 Vaccine</subject><subject>Body mass index</subject><subject>Brain death</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 vaccines</subject><subject>COVID-19 Vaccines - adverse effects</subject><subject>Drug dosages</subject><subject>Dyspnea</subject><subject>Humans</subject><subject>Immunoglobulin G</subject><subject>Lavage</subject><subject>Lung</subject><subject>Lung transplants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>mRNA Vaccines</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Pulmonary fibrosis</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Steroids</subject><subject>Surgical Oncology</subject><subject>Thoracic Surgery</subject><subject>Transplant Recipients</subject><issn>1863-6705</issn><issn>1863-6713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtv1DAUhS0EoqXwB1ggS2zYGPxKbLMbjcpDqkBqC1vLdm4GjzJOaieV5t_X0ylFYtGVr-zvnnt8D0JvGf3IKFWfCmNKakI5J5RprYh4hk6ZbgVpFRPPH2vanKBXpWwpbVrNmpfoRLRcG9bqU3Rz3vcxuLDHLnW4uB7mPR57PP8BfLW6vCLr8TfheHf5Y4VvXQgxAY4JD0va4Dm7VKbBpRlnCHGKkObyGTs8jaVEP0Al4mYD-SCYYQthjmN6jV70bijw5uE8Q7--nF-vv5GLn1-_r1cXJEgpZuKCa3zojZTeCdOCN0Y1TlPjJZVaqCBBy4550wXWqnrZGu6p8MoJzUUnxBn6cNSd8nizQJntLpYAQ_UL41IsV9w0nDHJK_r-P3Q7LjlVd5YbppXkdW2V4kcq5Pq_DL2dcty5vLeM2kMg9hiIrYHY-0DswcW7B-nF76B7bPmbQAXEESj1KdVl_Zv9hOwdef2Uyg</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Goda, Yasufumi</creator><creator>Nakajima, Daisuke</creator><creator>Tanaka, Satona</creator><creator>Yamada, Yoshito</creator><creator>Yutaka, Yojiro</creator><creator>Unagami, Kohei</creator><creator>Yoshikawa, Mikiko</creator><creator>Egawa, Hiroto</creator><creator>Date, Hiroshi</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection</title><author>Goda, Yasufumi ; Nakajima, Daisuke ; Tanaka, Satona ; Yamada, Yoshito ; Yutaka, Yojiro ; Unagami, Kohei ; Yoshikawa, Mikiko ; Egawa, Hiroto ; Date, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-aca5bcf944ba396eb9975a809b404837c4e84d1b9dc167b40692b03b7a3823d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antibodies</topic><topic>Antigens</topic><topic>BNT162 Vaccine</topic><topic>Body mass index</topic><topic>Brain death</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - prevention & control</topic><topic>COVID-19 vaccines</topic><topic>COVID-19 Vaccines - adverse effects</topic><topic>Drug dosages</topic><topic>Dyspnea</topic><topic>Humans</topic><topic>Immunoglobulin G</topic><topic>Lavage</topic><topic>Lung</topic><topic>Lung transplants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>mRNA Vaccines</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Pulmonary fibrosis</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Steroids</topic><topic>Surgical Oncology</topic><topic>Thoracic Surgery</topic><topic>Transplant Recipients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goda, Yasufumi</creatorcontrib><creatorcontrib>Nakajima, Daisuke</creatorcontrib><creatorcontrib>Tanaka, Satona</creatorcontrib><creatorcontrib>Yamada, Yoshito</creatorcontrib><creatorcontrib>Yutaka, Yojiro</creatorcontrib><creatorcontrib>Unagami, Kohei</creatorcontrib><creatorcontrib>Yoshikawa, Mikiko</creatorcontrib><creatorcontrib>Egawa, Hiroto</creatorcontrib><creatorcontrib>Date, Hiroshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>General thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goda, Yasufumi</au><au>Nakajima, Daisuke</au><au>Tanaka, Satona</au><au>Yamada, Yoshito</au><au>Yutaka, Yojiro</au><au>Unagami, Kohei</au><au>Yoshikawa, Mikiko</au><au>Egawa, Hiroto</au><au>Date, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection</atitle><jtitle>General thoracic and cardiovascular surgery</jtitle><stitle>Gen Thorac Cardiovasc Surg</stitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>71</volume><issue>4</issue><spage>251</spage><epage>257</epage><pages>251-257</pages><issn>1863-6705</issn><eissn>1863-6713</eissn><abstract>Objective
Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.
Methods
We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (
n
= 17) or mRNA-1273 (
n
= 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.
Results
There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9–10.2) vs 2.8 (1.9–4.0) years,
p
= 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250–500) vs 1000 (1000–1000) mg/day,
p
= 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.
Conclusions
The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>36289168</pmid><doi>10.1007/s11748-022-01887-3</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | General thoracic and cardiovascular surgery, 2023-04, Vol.71 (4), p.251-257 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings; ProQuest Central |
| subjects | Antibodies Antigens BNT162 Vaccine Body mass index Brain death Cardiac Surgery Cardiology COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 vaccines COVID-19 Vaccines - adverse effects Drug dosages Dyspnea Humans Immunoglobulin G Lavage Lung Lung transplants Medicine Medicine & Public Health mRNA Vaccines Original Article Patients Prospective Studies Pulmonary fibrosis SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Steroids Surgical Oncology Thoracic Surgery Transplant Recipients |
| title | Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection |
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