Multicenter Effort Assessing the Effects of COVID Infection and Vaccination on HLA Antibodies in Waitlisted Patients with ESRD

G. R. Roll¹, M. Cooper², H. Gebel³, K. M. Hitchman⁴, M. Hobeika⁵, J. Houp⁶, M. Kamoun⁷, J. Killian⁸, J. Kim⁹, V. Kumar¹⁰, M. Levine¹¹, T. Lunow-Luke¹, R. Parsons¹², D. Ranch¹³, P. Stock¹⁴, S. Yi¹⁵, R. Rajalingam¹⁶

¹UCSF Medical Center, San Francisco, CA, ²MedStar Georgetown Transplant Institute, Washington, DC, ³Emory University Hospital, Atlanta, GA, ⁴Pathology and Laboratory Medicine, University of Texas Health San Antonio, San Antonio, TX, ⁵Houston Methodist, Houston, TX, ⁶University of Alabama, Birmingham, AL, ⁷Hospital Univ of Pennsylvania, Philadelphia, PA, ⁸University of Alabama at Birmingham, Birmingham, AL, ⁹Surgery, Keck Medicine of USC, Los Angeles, CA, ¹⁰University of Alabama at Birmingham Hospital, Birmingham, AL, ¹¹University of Pennsylvania, Philadelphia, Pe, ¹²Emory University School of Medicine, Atlanta, GA, ¹³UT Health San Antonio, San Antonio, TX, ¹⁴Univ of California-San Francisco, San Francisco, CA, ¹⁵Houston Methodist Hospital, Houston, TX, ¹⁶Immunogenetics and Transplantation Laboratory (ITL), San Francisco, CA

Meeting: 2022 American Transplant Congress

Abstract number: 405

Keywords: COVID-19, HLA antibodies, Vaccination, Waiting lists

Topic: Clinical Science » Kidney » 44 - Kidney Acute Antibody Mediated Rejection

Session Information

Session Name: Kidney Immunosuppression: Desensitization & Acute Antibody Mediated Rejection

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 7, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 4:20pm-4:30pm

Location: Hynes Ballroom A

*Purpose: Although rare, infection and vaccination have been reported to result in human leukocyte antibodies (HLA). We analyzed the effect of SARS-CoV2 infection, or COVID-19 vaccination on HLA antibodies.

*Methods: Multicenter study of waitlisted renal transplant patients (pts) either infected with SARS-CoV2, or fully vaccinated against it with single antigen testing within 3 months prior, and 3 months after. Demographics and infection/vaccination details were collected. If the calculated panel reactive antibody (cPRA) changed specificities were collected. Pts with cPRA change were adjudicated by each center’s HLA laboratory director and coordinating center’s lab director.

*Results: Data from 5 centers, 409 pts with single antigen testing before and after infection or vaccination was analyzed. 282 pts had an initial cPRA of 0%, and 72 had an initial cPRA>80%. 30 pts (7.0%) had a change in cPRA, 17 (3.9%) had an increase and 13 (3.0%) a decrease. After adjudication no pts with a clinically significant HLA antibody specificity increase were identified. The differences have been largely influenced by one or two specificities with subtle fluctuations around the borderline of the participating centers’ mean fluorescence intensity cutoff for unacceptable antigen listing.

*Conclusions: To date, no clinically significant change in cPRA was seen in pts who were infected with SARS-CoV2 and recovered, nor pts fully vaccinated against COVID-19. This has implications for crossmatching at the time of organ offer after SARS-CoV2 infection or vaccination. Also, vaccination appears to be safe for waitlisted pts, even if they are sensitized.

To cite this abstract in AMA style:

Roll GR, Cooper M, Gebel H, Hitchman KM, Hobeika M, Houp J, Kamoun M, Killian J, Kim J, Kumar V, Levine M, Lunow-Luke T, Parsons R, Ranch D, Stock P, Yi S, Rajalingam R. Multicenter Effort Assessing the Effects of COVID Infection and Vaccination on HLA Antibodies in Waitlisted Patients with ESRD [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/multicenter-effort-assessing-the-effects-of-covid-infection-and-vaccination-on-hla-antibodies-in-waitlisted-patients-with-esrd/. Accessed June 19, 2025.

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