Antibody Response and Molecular Graft Surveillance in Kidney Transplant Recipients Following Sars-CoV-2 Vaccination

N. M. Ali¹, J. Miles², S. Mehta¹, V. Tatapudi¹, Z. Stewart¹, B. Lonze¹, M. Mangiola¹, C. DiMaggio¹, E. Weldon¹, I. Saeed¹, J. Leonard¹, R. Herati¹, J. Thomas¹, J. Michael¹, C. Hickson¹, K. Cartiera¹, R. Montgomery¹

¹Transplant Institute, NYU Langone Health, New York, NY, ²CareDx, Brisbane, NY

Meeting: 2022 American Transplant Congress

Abstract number: 1579

Keywords: COVID-19, Genomic markers, Kidney transplantation, Vaccination

Topic: Basic Science » Basic Clinical Science » 17 - Biomarkers: Clinical Outcomes

Session Information

Session Name: Biomarkers: Clinical Outcomes

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Preliminary studies suggest that kidney transplant recipients (KTRs) show diminished humoral responses to SARS-CoV-2 vaccination. Although reports of allograft rejection after SARS-CoV-2 vaccination have been rare, there is no recommended framework for monitoring for potential vaccine-related allograft injury. Here, we describe an approach for longitudinal assessment of immunogenicity and safety of SARS-COV-2 vaccination in KTRs.

*Methods: KTRs eligible for SARS-CoV-2 vaccination were identified through medical records, beginning March 12, 2021. Baseline and weekly blood samples were collected for SARS-CoV-2 spike protein antibody titers, dd-cfDNA and gene expression profiling (GEP) for 12 weeks. Donor specific antibody (DSA) testing was performed at baseline, 2 weeks after completion of vaccine doses and at week 12. Antibody response was defined as a 10-fold increase in total binding IgG titers.

*Results: 49 KTRs were identified for analysis. Patient demographics are shown in Table 1. Ten patients (20.4%) demonstrated a spike antibody response post- vaccination. Of responders, 80% (n=8) had a history of COVID-19. The odds ratio for the association of a history of COVID-19 with vaccine response was 18.3 (95% CI 3.2, 105.0, p=0.0005). Median dd-cfDNA levels did not differ between pre- and post-vaccination (0.23% versus 0.21% respectively). There was no significant difference between pre- and post-vaccination GEP scores (9.85 versus 10.4 respectively). No patients developed clinically significant DSA, eGFR decline or allograft rejection following vaccination.

*Conclusions: Quantitative antibody responses were strongly associated with a diagnosis of prior SARS-CoV-2 infection. Stability of eGFR, dd-cfDNA, GEP profiles and lack of allosensitization reinforce the safety profile of SARS-CoV-2 vaccination in KTRs. Further studies are needed to better understand immunogenicity in SARS-CoV-2 naïve individuals, including whether cellular responses are protective in the absence of humoral responses.

To cite this abstract in AMA style:

Ali NM, Miles J, Mehta S, Tatapudi V, Stewart Z, Lonze B, Mangiola M, DiMaggio C, Weldon E, Saeed I, Leonard J, Herati R, Thomas J, Michael J, Hickson C, Cartiera K, Montgomery R. Antibody Response and Molecular Graft Surveillance in Kidney Transplant Recipients Following Sars-CoV-2 Vaccination [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/antibody-response-and-molecular-graft-surveillance-in-kidney-transplant-recipients-following-sars-cov-2-vaccination/. Accessed July 12, 2025.

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