4953 IMPACT OF IMMUNOSUPPRESSIVE REGIMEN ON ANTIBODY RESPONSE AFTER CHADOX1 NCOV-19 VACCINATION IN THAI KIDNEY TRANSPLANT RECIPIENTS

• Published in: Nephrology, dialysis, transplantation Vol. 38; no. Supplement_1
• Main Authors: Larpparisuth, Nuttasith, Pongsakornkullachart, Kritsada, Vongwiwatana, Attapong, Skulratanasak, Peenida
• Format: Journal Article
• Language: English
• Published: 14.06.2023
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfad063c_4953

Abstract Background and Aims The lower humoral immunity response after COVID-19 vaccine in kidney transplant recipients (KTRs) has been reported in several studies. However, the study regarding efficacy of ChAdOx1 nCoV-19 (AstraZeneca) vaccine among various immunosuppressive treatments in Asian population is scarce. Method We conducted a cross-sectional study in Siriraj Hospital, Bangkok, Thailand. Adult KTRs who received two doses of the ChAdOx1 nCoV-19 vaccine at intervals of 3 months were enrolled. Anti-SARS-COV-2 S-RBD-IgG antibody (anti-RBD) was assessed at the one month after the second vaccine dose and considered positive if the level ≥ 50 AU/ml. Primary outcome was seropositivity of anti-RBD. Association between type, dose and level of immunosuppressive regimen, and seropositivity of anti-RBD were analyzed. The statistical analysis was performed using SPSS version 23.0. Results Between October 2021 and January 2022, 153 KTRs with median follow up time of 59 (30 – 125) months, were enrolled. Mean age was 49.3 ± 11 years and 61.4% were male. Regimen of tacrolimus (TAC)/mycophenolate (MPA)/prednisolone (CS), everolimus (EVR)/MPA/CS and TAC/EVR/CS were prescribed for 92 (60.1%), 23 (15%) and 24 (15.7%) patients, respectively. The anti-RBD ≥ 50 AU/ml after vaccination was observed in 82 patients (53.6%) with median level of 476.7 (129 – 1253.2) AU/ml. Patients received TAC/EVR/CS had significantly higher proportion of seropositivity than EVR/MPA/CS (95.8% vs 65.2%; p = 0.008) and TAC/MPA/CS regimen (95.8% vs 37%; p < 0.001). Among the seropositive KTRs, the median level of anti-S is significantly highest in TAC/EVR/CS treatment when compared to EVR/MPA/CS and TAC/MPA/CS group, respectively (1,204 vs 260.7 vs 315.4; p < 0.001). Among KTRs who received tacrolimus, the seropositivity was significantly higher in patients who had tacrolimus trough level < 3 ng/mL (83.3% vs 45.7%; p = 0.014). Conclusion The seropositivity of anti-S after vaccination with ChAdOx1 nCoV-19 in KTRs was 53.6% which was lower than general population. KTRs who received TAC/EVR/CS regimen had highest immune response after vaccination, which is relatively comparable to healthy control in Thailand. Immunosuppressive regimen should be considered for vaccine dose and schedule in the future.