Evaluating the Response and Safety of Inactivated COVID-19 Vaccines in Liver Transplant Recipients

Abstract

Purpose To evaluate the response and safety of an inactivated vaccine (Sinovac Life Sciences Co., Ltd., Beijing, China) for coronavirus disease 2019 (COVID-19) in liver transplant (LTx) recipients from China. Patients and Methods Thirty-five recipients post LTx from the First Affiliated Hospital of Zhejiang University School of Medicine who received inactivated vaccine from June to October 2021 were screened. Information regarding vaccine side effects and clinical data were collected. Results Thirty-five LTx recipients were enrolled, with a mean age of 46 years, and most patients were male (30, 85.71%). All the participants had a negative history of COVID-19 infection. Predictors for negative response in the recipients were interleukin-2 receptor (IL-2R) induction during LTx, shorter time post LTx and application of a derivative from mycophenolate acid (MPA). No serious adverse events were observed during the progress of vaccination or after the vaccination. Conclusion LTx recipients have a substantially partial immunological response to the inactivated vaccine for COVID-19. IL-2R induction during LTx, a shorter time post LTx and the application of a derivative from MPA seem to be predictors for a negative serological immunoglobulin G (IgG) antibody response in recipients. The findings require booster vaccination in these LTx recipients.

Omicron infections profile and vaccination status among 1881 liver transplant recipients: a multi-centre retrospective cohort

“…Prieto J. [ 31 ] investigated the protective effect of inactivated vaccines in 11 LT patients, Tu Z. H. [ 15 ] evaluated the safety of inactivated vaccines in 35 LT patients. Data on the safety and protection of inactivated vaccines in large-scale LT patients are not available, as yet.…”

“…Local and systemic AEs were mostly mild, with fatigue being the most frequently detected systemic AE. Previous studies reported that 27%−51% vaccinated LT patients had systemic AEs (mostly fatigue and headache) following two doses of vaccines [ 15 , 35 , 36 ]. Compared with liver cirrhosis and other chronic liver diseases [ 16 , 17 ], LT patients had a relatively higher proportion of systemic AEs, which might be due to their impaired immune systems.…”

“…However, patients with decompensated cirrhosis in eastern China largely remained at unvaccinated, particularly those with hepatic encephalopathy and liver transplant (LT) [ 14 ]. In addition, recent studies have shown that COVID-19 vaccinations result in an impaired or poor humoral response in people with chronic liver diseases [ 15–18 ]. Therefore, vaccination promotions and investigations of COVID-19 infection prognosis in LT patients are urgently needed.…”

COVID-19-associated liver injury, role of drug therapy and management: a review

“…However, a previous study has suggested that liver function indicators remain within normal after COVID-19 vaccination in liver transplant recipients, and incidences of compromised graft function, graft rejection, neurological conditions or severe allergic reaction are not likely to occur [ 22 ]. In their studies, Tu et al and Burra & Russo observed that immune response to the inactivated COVID-19 vaccine and mRNA SARS-CoV2 vaccine was generally low among liver transplant recipients [ 23 , 24 ], and shorter time post liver transplantation is a predictor of this [ 23 ]. However, COVID-19 vaccination is generally safe in liver transplant recipients [ 22 ].…”

SARS-CoV-2 vaccination in liver transplant recipients: We still haven't found what we are looking for

“…Data on the humoral response rates in LTR to different platforms of SARS-CoV-2 ranged from 17% to 87% after two doses, being significantly lower than in the general population [ 3 , 4 ]. The reduced immune response was more frequent in patients who received mycophenolate mofetil (MMF), those with a shorter time to transplantation and in patients with older age or with renal impairment [ 3 , [5] , [6] , [7] , [8] , [9] , [10] , [11] ].…”