Publication date: Aug 31, 2023

Antibodies against human leukocyte antigen (anti-HLA Abs) are associated with an increased risk of allograft loss. Herein, we report the prospective follow-up for anti-HLA Abs formation in 103 patients with end-stage kidney disease on the waiting list for transplantation who underwent COVID-19 vaccination. Sera were tested before and after vaccination using Luminex technology. The cohort comprised of 62 males and 41 females with a mean age of 56 +/- 14 years. The patients received BNT162b2 (80. 4%), mRNA-1273 (18. 5%), AZD1222 (0. 40%), or ChAdOx1-S (0. 80%) vaccine. Patients were tested before and within 119 +/- 50, 95 +/- 46 and 25 +/- 26 days after the first, second, and third dose of the vaccine, respectively. No significant change in calculated panel reactive antibody (cPRA) after vaccination was seen. Although 98. 1% of patients had no change in anti-HLA Abs profile or cPRA after vaccination, two patients (1. 9%) developed de novo anti-HLA Abs against class I or II HLA antigens. In those two patients, the cPRA changed from 0% and 63% at baseline to 9% and 90% after vaccination, respectively. Both patients received the BNT162b2 mRNA-based vaccine. The earliest detected anti-HLA Abs was 18 days after the first dose. In rare cases, new anti-HLA antibodies were observed after COVID-19 vaccination, with potential implications for transplantation. The low incidence of this phenomenon is outweighed by the clinical benefits of vaccination.

Semantics

Original Article