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Mycophenolate Interruption Restores Anti-SARS-CoV-2 Vaccine Immunogenicity in Unresponsive Liver Transplant Recipients.
Toniutto, Pierluigi; Cussigh, Annarosa; Cmet, Sara; Fabris, Martina; Curcio, Francesco; Bitetto, Davide; Fornasiere, Ezio; Fumolo, Elisa; Falleti, Edmondo.
Afiliação
  • Toniutto P; Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy.
  • Cussigh A; Clinical Pathology, Udine University Hospital, 33100 Udine, Italy.
  • Cmet S; Clinical Pathology, Udine University Hospital, 33100 Udine, Italy.
  • Fabris M; Clinical Pathology, Udine University Hospital, 33100 Udine, Italy.
  • Curcio F; Clinical Pathology, Udine University Hospital, 33100 Udine, Italy.
  • Bitetto D; Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy.
  • Fornasiere E; Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy.
  • Fumolo E; Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy.
  • Falleti E; Hepatology and Liver Transplantation Unit, Department of Specialized Medicine, Udine University Hospital, 33100 Udine, Italy.
Vaccines (Basel) ; 11(7)2023 Jun 27.
Article em En | MEDLINE | ID: mdl-37514981
BACKGROUND & AIMS: The fourth dose of anti-SARS-CoV-2 vaccine slightly improved the humoral response among previously seronegative liver transplant (LT) recipients. Mycophenolate (MMF) treatment worsens the vaccination response. This study aimed to evaluate whether temporary MMF interruption might improve the immunogenicity of the fourth anti-SARS-CoV-2 BNT16b2 vaccine dose in nonresponsive LT recipients. METHODS: LT recipients negative for anti-spike glycoprotein-specific immunoglobulin G receptor-binding domain (s-RBD) antibodies after the third vaccine dose were enrolled. Anti-SARS-CoV-2 spike-specific T-cell responses were measured before and 2 months following the fourth vaccine dose, and anti-SARS-CoV-2 s-RBD antibodies also 6 months thereafter. MMF was suspended two weeks before and after vaccination. RESULTS: Five LT recipients were enrolled. After a mean of 78 days after vaccination, all patients tested positive for anti-SARS-CoV-2 s-RBD antibodies. The mean antibody titer was 8944 UI/mL. The positive antibody response was maintained during a mean of 193 days of follow-up. Three patients developed a positive T-cell response. Two patients (one positive for T-cell response) developed a self-limited SARS-CoV-2 infection. CONCLUSIONS: Suspending MMF prior to the fourth dose of the anti-SARS-CoV-2 mRNA vaccine seems feasible and safe. This procedure could restore vaccine-induced immunogenicity in a large portion of previously nonresponsive LT recipients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Vaccines (Basel) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Itália País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Vaccines (Basel) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Itália País de publicação: Suíça