ESPN 54th Annual Meeting

ESPN 2022


 
Humoral and cellular immunity to SARS-CoV-2 vaccination with BNT162b2 mRNA vaccine in pediatric kidney transplant and dialysis patients
RUVEYDA GULMEZ 1 DOGUKAN OZBEY 2 AYSE AGBAS 1 BAGDAGUL AKSU 3 NURDAN YILDIZ 4 DIANA UCKARDES 5 SEHA SAYGILI 1 ZEYNEP YURUK YILDIRIM 3 MEHMET TASDEMIR 6 AYCA KIYKIM 7 HALUK COKUGRAS 8 NUR CANPOLAT 1 AHMET NAYIR 3 BEKIR S KOCAZEYBEK 2 SALIM CALISKAN 1

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY.
2- DEPARTMENT OF MICROBIOLOGY, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY.
3- DEPARTMENT OF PEDIATRIC NEPHROLOGY, FACULTY OF MEDICINE, ISTANBUL UNIVERSITY, ISTANBUL, TURKEY.
4- DEPARTMENT OF PEDIATRIC NEPHROLOGY, FACULTY OF MEDICINE, MARMARA UNIVERSITY, ISTANBUL, TURKEY.
5- DEPARTMENT OF PEDIATRIC NEPHROLOGY, FACULTY OF MEDICINE, ISTANBUL MEDENIYET UNIVERSITY, ISTANBUL, TURKEY.
6- DEPARTMENT OF PEDIATRIC NEPHROLOGY, ISTINYE UNIVERSITY LIV HOSPITAL BAHÇEŞEHIR, ISTANBUL, TURKEY.
7- DEPARTMENT OF PEDIATRIC ALLERGY AND IMMUNOLOGY, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY.
8- DEPARTMENT OF PEDIATRIC ALLERGY, CHEST DISEASES, INFECTIOUS DISEASES, DEPARTMENT OF PEDIATRICS, CERRAHPAŞA FACULTY OF MEDICINE, ISTANBUL UNIVERSITY-CERRAHPAŞA, ISTANBUL, TURKEY.
 
Introduction:

 

Immune response to SARS-CoV-2 vaccination is lower in kidney transplant (KTx) recipients compared with healthy individuals and dialysis patients. However, few data are available for the pediatric population. We aimed to investigate both humoral and cellular immune response to SARS-CoV-2 vaccination in pediatric KTx and dialysis patients.

Material and methods:

 

In this multicenter study, 61 patients (49 KTx, 12 dialysis) were evaluated for SARS-CoV-2 specific humoral (anti-spike IgG and neutralizing antibody) and cellular (T-cell interferon ɣ release assay; IGRA) immune responses at least one month after two doses of SARS-CoV-2 mRNA vaccine (BNT162b2).

Results:

 

The mean age was 16±2.7 years (54% male), and the median duration after vaccination was 56 (42;77) days. There was no difference between the dialysis and KTx groups considering a positive PCR test for SARS-CoV-2 before the second dose of vaccination. The dialysis group had significantly higher median anti-spike IgG titer than in the KTx group (p=0.007). The prevalence of positive anti-spike IgG, neutralizing antibody, and IGRA were also higher in the dialysis group than in the KTx group [100%, 83.3%, and 100% vs 75.5%, 64.4%, and 71.4%, respectively], but the differences were not statistically significant. In the KTx group, 57% of patients (n=24) had a complete response with both IgG and IGRA positive, but 12 patients had a partial response (Ig G or IGRA positive) and 6 patients had no response (IgG and IGRA negative). The incidence of history of acute rejection was significantly higher in patients with partial and no response than in patients with complete response (5/18 vs 0/24, p=0.018), but there were no differences between the two groups considering age, sex, transplant vintage, induction or maintenance therapy, or SARS-CoV-2 PCR positivity.

Conclusions:

 

In the pediatric population, KTx recipients had a lower immune response than dialysis patients after two doses of SARS-CoV-2 mRNA vaccine.