Decreased Long-term SARS-CoV-2-Specific Humoral Immunity in Liver Transplant Recipients 12-Months after COVID-19
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
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.
CITA DEL ARTÍCULO Liver Transpl. 2022 Jun;28(6):1039-1050.
doi: 10.1002/lt.26389. Epub 2022 Jan 17.