COVID-19 in orthotopic heart transplant recipients and association with donor specific antibodies

• Published in: Transplant immunology Vol. 75; p. 101712
• Main Authors: Yang, Bin Q., Vader, Justin M., Lambert, David S., Petrella, Richard, Schilling, Joel D., Verma, Amanda K.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2022
• Subjects: Brief Communication; COVID-19; Donor specific antibody; Graft Rejection; Graft Survival; Heart transplant; Heart Transplantation; HLA Antigens; Humans; Isoantibodies; Retrospective Studies; SARS-CoV-2; Transplant Recipients; COVID-19; MFI; SARS-CoV-2; DSA; Heart transplant; Donor specific antibody; AMR; SOT; OHT; AT1R
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2022.101712

De novo donor-specific antibodies (DSAs) are associated with increased risk of antibody-mediated rejection and worse clinical outcomes after orthotopic heart transplant (OHT). No study has reported the production of DSAs after infection by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in an OHT population. In this retrospective study, we described coronavirus disease 2019 (COVID-19) incidence and clinical course in a large, contemporary OHT cohort. We showed that the case-fatality rate has significantly decreased since the early days of the pandemic, although remains higher than that of the general population. In addition, we found that 10% of OHT recipients developed de novo DSAs or experienced an increase in pre-existing DSAs after COVID-19, with the majority occurring in unvaccinated patients (15% vs 2%). Further studies are necessary to substantiate our findings in an external cohort.