TY - JOUR
T1 - Seroconversion rates in kidney transplant recipients following SARS-CoV-2 vaccination and its association with immunosuppressive agents
T2 - a systematic review and meta-analysis
AU - Iryaningrum, Maria Riastuti
AU - Cahyadi, Alius
AU - Damara, Fachreza Aryo
AU - Bandiara, Ria
AU - Marbun, Maruhum Bonar Hasiholan
N1 - Publisher Copyright:
© Korean Vaccine Society.
PY - 2023/1
Y1 - 2023/1
N2 - This systematic and meta-analysis aims to evaluate humoral and cellular responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine among kidney transplant recipients (KTRs). We conducted a systematic literature search across databases to evaluate seroconversion and cellular response rates in KTRs receiving SARS-CoV-2 vaccines. We extracted studies that assessed seroconversion rates described as the presence of antibody de novo positivity in KTRs following SARS-CoV-2 vaccination published up to January 23rd, 2022. We also performed meta-regression based on immunosuppression therapy used. A total of 44 studies involving 5,892 KTRs were included in this meta-analysis. The overall seroconversion rate following complete dose of vaccines was 39.2% (95% confidence interval [CI], 33.3%–45.3%) and cellular response rate was 41.6% (95% CI, 30.0%–53.6%). Meta-regression revealed that low antibody response rate was significantly associated with the high prevalence of mycophenolate mofetil/mycophenolic acid (p=0.04), belatacept (p=0.02), and anti-CD25 induction therapy uses (p=0.04). Conversely, tacrolimus use was associated with higher antibody response (p=0.01). This meta-analysis suggests that postvaccination seroconversion and cellular response rates in KTRs are still low. And seroconversion rate was correlated with the type of immunosuppressive agent and induction therapy used. Additional doses of the SARS-CoV-2 vaccine for this population using a different type of vaccine are considered.
AB - This systematic and meta-analysis aims to evaluate humoral and cellular responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine among kidney transplant recipients (KTRs). We conducted a systematic literature search across databases to evaluate seroconversion and cellular response rates in KTRs receiving SARS-CoV-2 vaccines. We extracted studies that assessed seroconversion rates described as the presence of antibody de novo positivity in KTRs following SARS-CoV-2 vaccination published up to January 23rd, 2022. We also performed meta-regression based on immunosuppression therapy used. A total of 44 studies involving 5,892 KTRs were included in this meta-analysis. The overall seroconversion rate following complete dose of vaccines was 39.2% (95% confidence interval [CI], 33.3%–45.3%) and cellular response rate was 41.6% (95% CI, 30.0%–53.6%). Meta-regression revealed that low antibody response rate was significantly associated with the high prevalence of mycophenolate mofetil/mycophenolic acid (p=0.04), belatacept (p=0.02), and anti-CD25 induction therapy uses (p=0.04). Conversely, tacrolimus use was associated with higher antibody response (p=0.01). This meta-analysis suggests that postvaccination seroconversion and cellular response rates in KTRs are still low. And seroconversion rate was correlated with the type of immunosuppressive agent and induction therapy used. Additional doses of the SARS-CoV-2 vaccine for this population using a different type of vaccine are considered.
KW - Kidney transplant
KW - SARS-CoV-2
KW - Seroconversion
KW - Transplantation
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85148903103&partnerID=8YFLogxK
U2 - 10.7774/cevr.2023.12.1.13
DO - 10.7774/cevr.2023.12.1.13
M3 - Review article
AN - SCOPUS:85148903103
SN - 2287-3651
VL - 12
SP - 13
EP - 24
JO - Clinical and Experimental Vaccine Research
JF - Clinical and Experimental Vaccine Research
IS - 1
ER -