Background. Adult solid organ transplant recipients (SOTRs) have decreased responsiveness to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination and higher incidence of infection, but there are few data on the serological response in pediatric SOTR. The aim of this study was to determine serological response to SARS-CoV-2 vaccination in pediatric liver (LT) and kidney transplant (KT) recipients and compare it with adult SOTR. Methods. A European, prospective, multicenter study was performed. Samples were taken at 7 and 32 wk following COVID-19 vaccination and serological endpoints were measured by ELISA. Results. A total of 42 pediatric (16 post-LT and 26 post-KT) and 117 adult (all post-LT) were included. All pediatric participants and 94% adult participants received mRNA vaccines. Paediatric SOTR patients had significantly higher anti-Spike IgG levels than adult participants at week 7 (114 220.7 [59 285.92-220 058.55] versus 8756.7 [5643.69-13 586.71], P < 0.0001) and week 32 (46 113.2 [10 992.91-193 436.14] versus 8207.0 [3561.20-18 913.43], P = 0.0032). No significant difference in week 7 anti-Spike IgG response was found between pediatric LT and KT (129 434.4 [51 888.64-322 869.69] versus 105 304.5 [39 910.20-277 849.50], P = 0.9854). No differences were seen between children and adults in the rate of decline of anti-Spike IgG between weeks 7 and 32 (P = 0.8000). Male sex and hemolytic-uremic syndrome or postischemic kidney disease were associated with lower anti-Spike IgG levels at week 7 in pediatric SOTR. Conclusions. Paediatric SOTR demonstrate greater SARS-CoV-2 vaccine responses than comparable adult SOTR patients. These data support efficacy and safety of SARS-CoV-2 vaccination in child SOTR and may alleviate vaccine hesitancy in this patient group.
Pediatric liver and kidney transplant recipients demonstrate greater serological response to sars-cov-2 vaccination than adults / Laue, Tobias; Ballester, Maria Pilar; Meoli, Lily; Grabitz, Carl; Uson, Eva; D´antiga, Lorenzo; Mclin, Valerie; Pujadas, Montserrat; Carvalho-Gomes, Ângela; Sahuco, Ivan; Bono, Ariadna; D'Amico, Federico; Viganò, Raffaela; Diago, Elena; Lanseros, Beatriz Tormo; Inglese, Elvira; Vazquez, Dani Martinez; Broekhoven, Annelotte; Kikkert, Marjolein; Morales, Shessy P. Torres; Myeni, Sebenzile K.; Riveiro-Barciela, Mar; Palom, Adriana; Zeni, Nicola; Brocca, Alessandra; Cussigh, Annarosa; Cmet, Sara; Escudero-García, Maria Desamparados; Stocco, Matteo; Natola, Leonardo Antonio; Ieluzzi, Donatella; Paon, Veronica; Sangiovanni, Angelo; Farina, Elisa; Dibenedetto, Clara; Sánchez-Torrijos, Yolanda; Lucena-Varela, Ana; Román, Eva; Sánchez, Elisabet; Sánchez-Aldehuelo, Rubén; López-Cardona, Julia; Jeyanesan, Dhaarica; Morocho, Alejandro Esquivel; Canas-Perez, Itzel; Eastgate, Christine; Di Cola, Simone; Lapenna, Lucia; Zaccherini, Giacomo; Bongiovanni, Deborah; Riva, Antonio; Sharma, Rajni; Tsou, Hio Lam Phoebe; Harris, Nicola; Zanaga, Paola; Sayaf, Katia; Hossain, Sabir; Crespo, Javier; Robles-Díaz, Mercedes; Madejón, Antonio; Degroote, Helena; Korenjak, Marko; Verhelst, Xavier; García-Samaniego, Javier; Andrade, Raúl J.; Iruzubieta, Paula; Wright, Gavin; Caraceni, Paolo; Merli, Manuela; Patel, Vishal C.; Gander, Amir; Albillos, Agustín; Soriano, Germán; Donato, Maria Francesca; Sacerdoti, David; Toniutto, Pierluigi; Buti, Maria; Duvoux, Christophe; Grossi, Paolo Antonio; Berg, Thomas; Polak, Wojciech G.; Puoti, Massimo; Bosch-Comas, Anna; Belli, Luca S.; Burra, Patrizia; Russo, Francesco Paolo; Coenraad, Minneke; Calleja, José Luis; Perricone, Giovanni; Chokshi, Shilpa; Berenguer, Marina; Clària, Joan; Moreau, Richard; Fernández, Javier; Arroyo, Vicente; Angeli, Paolo; Sánchez-Garrido, Cristina; Ampuero, Javier; Piano, Salvatore; Nicastro, Emanuele; Rock, Nathalie; Shawcross, Debbie; Edwards, Lindsey; Mutschler, Frauke; Melk, Anette; Mehta, Gautam; Baumann, Ulrich; Jalan, Rajiv. - In: TRANSPLANTATION DIRECT. - ISSN 2373-8731. - 11:5(2025), pp. 1-9. [10.1097/txd.0000000000001787]
Pediatric liver and kidney transplant recipients demonstrate greater serological response to sars-cov-2 vaccination than adults
D'Amico, Federico;Di Cola, Simone;Lapenna, Lucia;Merli, ManuelaInvestigation
;Fernández, Javier;
2025
Abstract
Background. Adult solid organ transplant recipients (SOTRs) have decreased responsiveness to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination and higher incidence of infection, but there are few data on the serological response in pediatric SOTR. The aim of this study was to determine serological response to SARS-CoV-2 vaccination in pediatric liver (LT) and kidney transplant (KT) recipients and compare it with adult SOTR. Methods. A European, prospective, multicenter study was performed. Samples were taken at 7 and 32 wk following COVID-19 vaccination and serological endpoints were measured by ELISA. Results. A total of 42 pediatric (16 post-LT and 26 post-KT) and 117 adult (all post-LT) were included. All pediatric participants and 94% adult participants received mRNA vaccines. Paediatric SOTR patients had significantly higher anti-Spike IgG levels than adult participants at week 7 (114 220.7 [59 285.92-220 058.55] versus 8756.7 [5643.69-13 586.71], P < 0.0001) and week 32 (46 113.2 [10 992.91-193 436.14] versus 8207.0 [3561.20-18 913.43], P = 0.0032). No significant difference in week 7 anti-Spike IgG response was found between pediatric LT and KT (129 434.4 [51 888.64-322 869.69] versus 105 304.5 [39 910.20-277 849.50], P = 0.9854). No differences were seen between children and adults in the rate of decline of anti-Spike IgG between weeks 7 and 32 (P = 0.8000). Male sex and hemolytic-uremic syndrome or postischemic kidney disease were associated with lower anti-Spike IgG levels at week 7 in pediatric SOTR. Conclusions. Paediatric SOTR demonstrate greater SARS-CoV-2 vaccine responses than comparable adult SOTR patients. These data support efficacy and safety of SARS-CoV-2 vaccination in child SOTR and may alleviate vaccine hesitancy in this patient group.| File | Dimensione | Formato | |
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