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ウナガミ コウヘイ
UNAGAMI Kouhei
海上 耕平 所属 医学部 医学科（東京女子医科大学病院） 職種 講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Efficacy and safety of the SARS-CoV-2 mRNA vaccine in lung transplant recipients: a possible trigger of rejection. |
| 掲載誌名 | 正式名：General thoracic and cardiovascular surgery 略 称：Gen Thorac Cardiovasc Surg ISSNコード：18636713/18636705 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 71(4),pp.251-257 |
| 著者・共著者 | GODA Yasufumi, NAKAJIMA Daisuke, TANAKA Satona, YAMADA Yoshito, YUTAKA Yojiro, UNAGAMI Kohei, YOSHIKAWA Mikiko, EGAWA Hiroto, DATE Hiroshi |
| 発行年月 | 2023/04 |
| 概要 | OBJECTIVE:Solid organ transplant recipients have an increased risk of developing severe coronavirus disease 2019 (COVID-19). Although SARS-CoV-2 mRNA vaccination has been strongly recommended for solid organ transplant recipients, its efficacy and safety have remained unknown.METHODS:We performed an observational prospective cohort study in 18 lung transplant recipients who received two doses of SARS-CoV-2 mRNA vaccine, including BNT162b2 (n = 17) or mRNA-1273 (n = 1), between June and October 2021. The titers of IgG antibodies against the SARS-CoV-2 spike protein (S-IgG) were measured in serum samples collected before the prime dose, three weeks after the prime dose, and four weeks after the booster dose. Reactogenicity and adverse events were evaluated after vaccination.RESULTS:There were no recipients with previous SARS-CoV-2 infection prior to vaccination. S-IgG levels were elevated in 2/18 (11.1%) recipients after the prime dose and in 5/18 recipients (27.8%) after the booster dose (31.7 ± 30.6 U/ml). The time from transplantation to vaccination tended to be longer in the seropositive group than the seronegative group [7.5 (3.9-10.2) vs 2.8 (1.9-4.0) years, p = 0.059]. Maintenance dose of mycophenolate mofetil tended to be lower in the seropositive group than in the seronegative group [500 (250-500) vs 1000 (1000-1000) mg/day, p = 0.088]. Regarding the adverse events after vaccination, the development of chronic lung allograft dysfunction (CLAD) or antibody-mediated rejection (AMR) were observed in two seropositive patients.CONCLUSIONS:The antibody response to the SARS-CoV-2 mRNA vaccine was quite poor in lung transplant recipients. We experienced cases that developed clinical CLAD or AMR that was likely related to SARS-CoV-2 vaccination. |
| DOI | 10.1007/s11748-022-01887-3 |
| PMID | 36289168 |