Kidney transplant recipients vaccinated before transplantation maintain superior humoral response to SARS-CoV-2 vaccine

Ayelet Grupper*, Eugene Katchman, Merav Ben-Yehoyada, Liane Rabinowich, Doron Schwartz, Idit F. Schwartz, Moshe Shashar, Tami Halperin, Dan Turner, Yaacov Goykhman, Oren Shibolet, Sharon Levy, Inbal Houri, Roni Baruch, Helena Katchman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Majority of transplant recipients did not develop an appreciable humoral response following SARS-CoV-2 vaccine, in contrast to dialysis patients and healthy individuals. We analyzed the serologic response to BNT162b2 (Pfizer-BioNTech) vaccine in a cohort of 19 kidney transplant recipients, vaccinated prior to transplantation, compare to 109 recipients vaccinated after transplantation, and to 39 healthcare workers, by determining the level of anti-spike antibodies after transplantation. All controls and 17 of 19 (90%) of recipients vaccinated before transplant were seropositive, while only 49 of 109 (45%) recipients vaccinated post-transplant had positive serology (P <.001). Median anti-spike IgG in the group of kidney transplant recipients vaccinated after transplantation (10.7 AU/ml, [IQR 0–62.5]) was lower than the patients vaccinated before transplantation (66.2 AU/ml [21.6–138]), which was significantly lower than in the controls (156 AU/ml [99.7–215.5]). Negative humoral response was associated with vaccination post transplantation (odds ratio 22.4), older age (OR = 1.04), and longer time on dialysis (OR = 1.02), while higher lymphocyte count at time of vaccination was protective (OR =.52). Our findings of sustained superior humoral response to SARS-CoV-2 vaccine in kidney transplant recipients vaccinated prior to transplantation strongly support the recommendations of SARS-CoV-2 vaccination of transplant candidates, especially those younger than 60 years.

Original languageEnglish
Article numbere14478
JournalClinical Transplantation
Issue number12
StatePublished - Dec 2021


  • COVID-19
  • Kidney transplantation
  • SARS-CoV-2
  • vaccine


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