By writer to onlinelibrary.wiley.com
Kidney transplant recipients (KTRs) are extraordinarily susceptible to SARS-CoV-2 an infection and present an impaired immune response to SARS-CoV-2 vaccination. We analyzed components associated to vaccination effectivity in KTRs. In a multicenter potential observational examine (NCT04743947), IgG antibodies ranges in opposition to SARS-CoV-2 spike S1 subunit and their neutralization capability after SARS-CoV-2 vaccination had been analyzed in 225 KTRs and in comparison with 176 controls. After the vaccination, 56 (24.9%) KTRs grew to become seropositive of whom 68% had neutralizing antibodies. This immune response was considerably decrease in comparison with controls [239 (78–519) BAU/ml versus 1826 (560–3180) BAU/ml for KTRs and controls, p<0.0001]. The strongest predictor for an impaired response was mycophenolate mofetil (MMF) remedy. Multivariate regression evaluation revealed that MMF-free routine was extremely related to seroconversion (OR 13.25, 95% CI 3.22–54.6; p<0.001). In distinction, different immunosuppressive medication had no important affect. 187 out of 225 KTRs had been handled with MMF of whom 26 (13.9%) developed antibodies. 23 of those seropositive KTRs had a every day MMF dose ≤1g. Moreover, larger trough MMF concentrations correlated with decrease antibody titers (R -0.354, p<0.001) supporting a dose-dependent unfavorable impact of MMF. Our information point out that MMF dose modification may result in an improved immune response.