Safety and infectious outcomes in pediatric kidney transplant recipients after COVID-19 vaccination: A pediatric nephrology research consortium study

被引：1

作者：

Churilla, Travis ^{[1
]}

Crane, Clarkson ^{[2
]}

Sreedharan, Rajasree ^{[3
]}

Alzarka, Bakri J. ^{[4
]}

Charnaya, Olga ^{[5
]}

Jain, Namrata G. ^{[6
]}

Pizzo, Helen ^{[7
]}

Mansuri, Asifhusen ^{[8
]}

Jain, Amrish ^{[9
]}

Grewal, Manpreet ^{[9
]}

Fishbein, Joseph D. ^{[10
]}

Kula, Alexander J. ^{[10
]}

Heald-Sargent, Taylor ^{[11
]}

Matossian, Debora ^{[10
]}

Verghese, Priya S. ^{[10
]}

机构：

[1] Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pediat, Chicago, IL 60611 USA

[2] Univ Calif San Diego, Div Pediat Nephrol, San Diego, CA USA

[3] Med Coll Wisconsin, Div Pediat Nephrol, Milwaukee, WI USA

[4] Univ Maryland, Sch Med, Dept Pediat, Baltimore, MD USA

[5] Johns Hopkins Univ, Dept Pediat, Baltimore, MD USA

[6] Hackensack Univ, Joseph M Sanzari Childrens Hosp, Med Ctr, Div Pediat Nephrol, Hackensack, NJ USA

[7] Cedars Sinai Med Ctr, Div Pediat Nephrol, Los Angeles, CA USA

[8] Augusta Univ, Childrens Hosp Georgia, Augusta, GA USA

[9] Cent Michigan Univ, Childrens Hosp Michigan, Div Pediat Nephrol, Detroit, MI USA

[10] Ann & Robert H Lurie Childrens Hosp Chicago, Div Nephrol, Chicago, IL USA

[11] Ann & Robert H Lurie Childrens Hosp Chicago, Div Infect Dis, Chicago, IL USA

来源：

PEDIATRIC TRANSPLANTATION | 2024年 / 28卷 / 04期

关键词：

COVID-19; donor-specific antibody; infection; kidney; pediatric; SARs-CoV-2; transplant; HLA ANTIBODIES;

D O I：

10.1111/petr.14786

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

BackgroundAdult kidney transplant recipients (KTRs) fully vaccinated against COVID-19 have substantial morbidity and mortality related to SARS-CoV-2 infection compared with the general population. However, little is known regarding the safety and efficacy of the COVID-19 vaccination series in pediatric KTRs.MethodsA multicenter, retrospective observational study was performed across nine pediatric transplantation centers. Eligible KTRs fully vaccinated against COVID-19 were enrolled and data were collected pertaining to SARS-CoV-2 infection incidence and severity, graft outcomes and post-vaccination safety profile, as well as overall patient survival.ResultsA total of 247 patients were included in this investigation with a median age at transplantation of 11 years (IQR 5-15). SARS-CoV-2 infection was observed in 30/110 (27.27%) of fully vaccinated patients, tested post-transplant, within the defined follow-up period. Of these patients, 6/30 (18.18%) required hospitalization and 3/30 (12.12%) required reduction in immunosuppression, with no reported deaths. De novo donor-specific antibodies (DSAs) were found in 8/86 (9.30%) of DSA-tested patients with two experiencing rejection and subsequent graft loss. The overall incidence of rejection and graft loss among the total cohort was 11/247 (4.45%) and 6/247 (3.64%), respectively. A 100% patient survival was observed.ConclusionsObservationally, infectious outcomes of SARS-CoV-2 in fully vaccinated pediatric KTRs are excellent, with a low incidence of infection requiring hospitalization and no associated deaths. Though de novo DSAs were observed, there was minimal graft rejection and graft loss reported in the total cohort. This observational, retrospective investigation demonstrates temporal associations pointing to a reassuring vaccine safety profile and mild SARS-Cov-2 infectious phenotype in pediatric renal transplant recipients fully vaccinated against COVID-19.image

引用

页数：8

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