Sars-cov2 Antibody Kinetics and Durability Three and Six Months After Two-Doses of MRNA Vaccination in Liver Transplant Recipients
1Johns Hopkins University School of Medicine, Baltimore, MD, 2University of Wisconsin School of Medicine, Madison, WI
Meeting: 2022 American Transplant Congress
Abstract number: 981
Keywords: Antibodies, COVID-19, Liver transplantation, Vaccination
Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: All Infections (Excluding Kidney & Viral Hepatitis) II
Session Type: Poster Abstract
Date: Sunday, June 5, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: nti-spike antibody response to SARS-CoV-2 vaccination is diminished in LT recipients compared to the general population so understanding durability for those that do respond is critical to mitigating risks of infection. We measured serial antibody titers in LT recipients for 6 months after two-dose mRNA vaccine series to describe kinetics and sero-reversion rates.
*Methods: LT recipients without known prior COVID-19 had anti-spike antibody testing at 1, 3, and 6 months after the second dose of mRNA vaccine (D2) using two commercial assays (Roche Elecsys anti-receptor binding domain immunoassay (EIA) [positive ≥0.8 U/mL] or EUROIMMUN anti-S1 EIA [positive ≥1.1 AU]). We compared titer distributions over time and identified factors associated with sero-reversion.
*Results: 180 LT recipients received BNT162b2 (48%) or mRNA-1273 (52%) 2-dose series between 1/7/2021 – 5/7/2021.
At 1 month post-D2 (n=173), 146 (84%) had positive antibody levels at a median (IQR) of 30 (28, 32) days post-D2. At 3 months post-D2 (n=164), 149 (91%) had positive levels at a median of 92 (90, 96) days post-D2. At 6 months post-D2 (n=73), 62 (85%) had positive levels at a median of 180 (176, 185) days post-D2. Among the 66 seropositive at 1 or 3 months post-D2, 58 (88%) remained seropositive by 6 months post-D2. Neither age, years since transplant, vaccine type, nor mycophenolate (MMF) use were associated with sero-reversion, though there was a trend toward more triple immunosuppressive use (25% vs 3%, p=0.07).
Of those Roche-tested, the median anti-RBD levels were ≥250 U/mL (14, ≥250; n=120) at 1 month post-D2, ≥250 U/mL (58, ≥250; n=113) at 3 months, and ≥250 U/mL (30, ≥250; n=49) at 6 months . Of those EUROIMMUN-tested, the median anti-S1 levels were 7.25 AU (4.31, 8.71; n=53) at 1 month, 5.71 AU (1.27, 7.90; n=51) at 3 months, and 1.73 AU (0.76, 6.01; n=25) at 6 months.
*Conclusions: Overall, most LT recipients demonstrated 6 month durability of anti-spike antibody following vaccination, but a subset did sero-revert, potentially associated with heavier immunosuppression. Further investigation into clinical consequences of waning antibody levels is key to guide timing of additional vaccine doses.
To cite this abstract in AMA style:
Chang A, Strauss AT, Chiang TP, Jennifer A, Nicole H, Zeiser L, Boyarsky B, Avery R, Tobian A, Levan M, Warren D, Massie A, Garonzik-Wang J, Segev D, Werbel W. Sars-cov2 Antibody Kinetics and Durability Three and Six Months After Two-Doses of MRNA Vaccination in Liver Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/sars-cov2-antibody-kinetics-and-durability-three-and-six-months-after-two-doses-of-mrna-vaccination-in-liver-transplant-recipients/. Accessed May 18, 2025.« Back to 2022 American Transplant Congress