COVID-19 INFECTION AND VACCINATION DO NOT IMPACT HLA ANTIBODY PROFILES IN WAITLISTED RENAL TRANSPLANT CANDIDATES- A MULTICENTER STUDY

• Authors: Garrett R Roll, University of California San Francisco; Robert Bray, Emory University; Matthew Cooper, Medstar-Georgetown Transplant Institute; Todd N Eagar, Immunogenetics and Transplantation Laboratory Houston Methodist, Houston; Howard Gebel, Emory University; Gayle M Vranic, Medstar-Georgetown Transplant Institute; Kelley M.K Hitchman, University of Texas Health Science Center, San Antonio; Julie Houp, University of Alabama Medical Center; Malek Kamoun, University of Pennsylvania; John Killian, University of Alabama Birmingham; Jim Kim, University of Southern California; Vineeta Kumar, University of Alabama Birmingham; Matthew Levine, University of Pennsylvania; Brendan P Lovasik, Emory University; Tyler Lunow-Luke, University of California San Francisco; Ronald Parsons, Emory University; Vikram Pattanayak, Massachusetts General Hospital; Daniel Ranch, University of Texas Health Science Center at San Antonio; Anushi Shah, Massachusetts General Hospital; Peter G Stock, University of California San Francisco; Olga A Timofeeva, Temple University; Jennifer Trofe-Clark, University of Pennsylvania; Chelsey Wongjirad, University of Southern California; Heidi Yeh, Massachusetts General Hospital; Stephanie Yi, Houston Methodist; Raja Rajalingam, University of California San Francisco
• Journal Title: HUMAN IMMUNOLOGY
• Volume: Volume 83, Number 4
• Publisher: ELSEVIER SCIENCE INC | 2022-11-01, Pages 100-100
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.humimm.2023.02.005
• Subjects: Health Sciences, Medicine and Surgery; Health Sciences, Pathology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology

Abstract

Although rare, infection and vaccination can result in antibodies to human leukocyte antigens (HLA). We analyzed the effect of SARS-CoV-2 infection or vaccination on HLA antibodies in waitlisted renal transplant candidates. Specificities were collected and adjudicated if the calculated panel reactive antibodies (cPRA) changed after exposure. Of 409 patients, 285 (69.7 %) had an initial cPRA of 0 %, and 56 (13.7 %) had an initial cPRA > 80 %. The cPRA changed in 26 patients (6.4 %), 16 (3.9 %) increased, and 10 (2.4 %) decreased. Based on cPRA adjudication, cPRA differences generally resulted from a small number of specificities with subtle fluctuations around the borderline of the participating centers’ cutoff for unacceptable antigen listing. All five COVID recovered patients with an increased cPRA were female (p = 0.02). In summary, exposure to this virus or vaccine does not increase HLA antibody specificities and their MFI in approximately 99 % of cases and 97 % of sensitized patients. These results have implications for virtual crossmatching at the time of organ offer after SARS-CoV-2 infection or vaccination, and these events of unclear clinical significance should not influence vaccination programs.