Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
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SARS-CoV-2 vaccination-induced immunogenicity in heart transplant recipients
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S. T. Küppers1, F. Memenga2, K. Borof1, P. Kirchhof1, P. Duengelhoef3, M. Barten4, M. Luetgehetmann3, F. Berisha2, N. Fluschnik2, P. M. Becher5, C. Kondziella1, A. M. Bernhardt4, H. Reichenspurner4, S. Blankenberg1, C. Magnussen1, M. Rybczynski2
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1Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; 2Allgemeine und Interventionelle Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; 3Universitätsklinikum Hamburg-Eppendorf, Hamburg; 4Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; 5Klinik und Poliklinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg;
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Aim:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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https://dgk.org/kongress_programme/jt2023/aP1722.html
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