Background and objectives Kidney transplant recipients are highly vulnerable to the serious complications of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infections and thus stand to benefit from vaccination. Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. Design, setting, participants, & measurements A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Results Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). Antibody response was associated with greater estimated glomerular filtration (eGFR) rate [odds ratio (OR), for every 10 ml/min/1.73m2 = 1.40 (1.19–1.66), P<0.001] whereas, non-response was associated with mycophenolic acid immunosuppression [OR, 0.02(0.01–0.11), p<0.001] and increasing age [OR per 10year increase, 0.61(0.48–0.78), p<0.001]. In the propensity-score analysis of four treatment variables (vaccine type, mycophenolic acid, corticosteroid, and triple immunosuppression), only mycophenolic acid was significantly associated with vaccine response [adjusted OR by PSA 0.17 (0.07–0.41): p<0.001]. 22 SARS-COV-2 infections were recorded in our cohort following vaccination. 17(77%) infections, with 3 deaths, occurred in the non-responder group. No death occurred in the responder group. Conclusion Vaccine response in allograft recipients after two doses of SARS-COV-2 vaccine is poor compared to the general population. Maintenance with mycophenolic acid appears to have the strongest negative impact on vaccine response.

Introduction Readmission following a percutaneous coronary intervention (PCI) procedure is undesirable, being associated with patient morbidity and financial penalties. US data suggest 30 day readmission rates of approximately 10%, however little data is available within the UK. Reductions in the length of stay following PCI potentially increase the likelihood of early readmission. This study reviewed readmission's following PCI undertaken in a non-surgical PCI centre in the UK. Methods Hospital admission databases were reviewed for all patients who had undergone a PCI at the centre. All patients who were readmitted to the Trust within 30 days of their PCI were identified, and a retrospective analysis was then undertaken of their hospital records. Results The data set comprised of 3754 patients who had all undergone at least one PCI procedure over the past 6 years. Of these, 409 patients (10.9%) were readmitted within 30 days. A significantly greater proportion of readmission's within 30 days had an index PCI for acute coronary syndrome (ACS, 63.8% vs. 49.6%, p<0.01). Index PCI procedural success was high and comparable between the group of patients who were readmitted and those who were not.