Scientific publications

Decreased Long-term SARS-CoV-2-Specific Humoral Immunity in Liver Transplant Recipients 12-Months after COVID-19

Jun 1, 2022 | Magazine: Liver Transplantation

Aránzazu Caballero-Marcos  1   2 , María Jesús Citores  3 , Roberto Alonso-Fernández  4 , Manuel Rodríguez-Perálvarez  2   5 , Maricela Valerio  4 , Javier Graus Morales  6 , Valentín Cuervas-Mons  7   8 , Alba Cachero  9 , Carmelo Loinaz-Segurola  10 , Mercedes Iñarrairaegui  11 , Lluís Castells  2   12 , Sonia Pascual  13 , Carmen Vinaixa-Aunés  2   14 , Rocío González-Grande  15 , Alejandra Otero  16 , Santiago Tomé  17 , Javier Tejedor-Tejada  18 , Ainhoa Fernández-Yunquera  1   2 , Luisa González-Diéguez  19 , Flor Nogueras-Lopez  20 , Gerardo Blanco-Fernández  21 , Fernando Díaz-Fontenla  1   2 , Francisco Javier Bustamante  22 , Mario Romero-Cristóbal  1   2 , Rosa Martin-Mateos  6 , Ana Arias-Milla  7 , Laura Calatayud  23 , Alberto A Marcacuzco-Quinto  10 , Víctor Fernández-Alonso  1 , Concepción Gómez-Gavara  12 , Patricia Muñoz  4 , Rafael Bañares  1   2 , José Antonio Pons  24 , Magdalena Salcedo  1   2


Abstract

Long-term humoral immunity and its protective role in liver transplant patients has not been elucidated. We performed a prospective multicenter study to assess the persistence of IgG antibodies in liver transplant recipients 12 months after coronavirus disease 2019 (COVID-19).

A total of 65 liver transplant recipients were matched with 65 non-transplanted patients by a propensity score including variables with recognized impact on COVID-19. Liver transplant recipients showed a lower prevalence of anti-nucleocapsid (27.7% vs. 49.2%, P = 0.02) and anti-spike IgG antibodies (88.2% vs. 100.0%, P = 0.02) at 12 months.

Lower index values of anti-nucleocapsid IgG antibodies were also observed in transplant patients one year after COVID-19 (0.49 [IQR 0.15-1.40] vs. 1.36 [IQR 0.53-2.91], P < 0.001).

Vaccinated liver transplant recipients showed higher antibody levels compared to unvaccinated patients (P < 0.001); antibody levels reached after vaccination were comparable to those observed in non-transplanted individuals (P = 0.70). In liver transplant patients, a longer interval since transplantation (OR=1.10, 95% CI 1.01-1.20) was independently associated with persistence of anti-nucleocapsid IgG antibodies one-year postinfection.

In conclusion, compared with non-transplanted patients, liver transplant recipients show a lower long-term persistence of anti-SARS-CoV-2 antibodies. However, SARS-CoV-2 vaccination after COVID-19 in liver transplant patients achieves a significant increase in antibody levels, comparable to that of non-transplanted patients.

CITATION  Liver Transpl. 2022 Jun;28(6):1039-1050.
doi: 10.1002/lt.26389. Epub 2022 Jan 17.