The Interplay Between Human Leukocyte Antigen Antibody Profile and COVID-19 Vaccination in Waitlisted Renal Transplant Patients

• DOI: 10.5858/arpa.2023-0370-oa
• Publication Date: 2024-04-11T00:01:22Z
• Authors: Yayuan Zhao; Pramath Kakodkar; Henry Pan; Richard Zhu; Khalid Musa; Abubaker Hassan; Ahmed Shoker; Destinie Webster; Twyla Pearce; Pouneh Dokouhaki; Fang Wu; Ahmed Mostafa
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Context.— Mass COVID-19 vaccination is mandated in vulnerable populations in our renal transplant waitlist cohort. However, the anti–human leukocyte antigen (anti-HLA) profile after COVID-19 vaccination is controversial, and the side effects are yet to be discerned.

Objective.— To evaluate the status of HLA antibodies in waitlisted renal transplant patients before and 3 weeks after each vaccination and if comorbidities are associated with the HLA antibody profile.

Design.— A total of 59 waitlisted kidney transplant patients were included in this study. The anti-HLA antibodies were analyzed before and 6 months after their last COVID-19 vaccination. The mean fluorescence intensity change in the anti-HLA antibody levels was used to classify patients into 3 groups: high inducers, low inducers, and noninducers.

Results.— There were significant HLA antibody profile changes after COVID-19 vaccination, showing 21 antibodies generated against HLA class I antigens and 7 against HLA class II antigens to their baseline. Compared with the noninducers, the high and low inducers showed a higher prevalence of COVID-19 infection, COVID-19 vaccine type, and background hypertension history.

Conclusions.— Our data suggest that COVID-19 vaccination propagates anti-HLA class I and II antibodies for waitlisted renal transplant patients. The clinical significance of these antibodies needs further study. Furthermore, comorbidities, such as history of COVID-19 infection and hypertension, supplemented this effect. Anti-HLA antibody monitoring may be warranted in COVID-19 vaccinated, waitlisted renal transplant patients with a history of COVID-19 infection and/or hypertension.