Publication:
Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients.

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Date

2020-07-16

Authors

Cordero, Elisa
Bulnes-Ramos, Angel
Aguilar-Guisado, Manuela
Gonzalez Escribano, Francisca
Olivas, Israel
Torre-Cisneros, Julian
Gavalda, Joan
Aydillo, Teresa
Moreno, Asuncion
Montejo, Miguel

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Frontiers Research Foundation
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Abstract

Our goal was to study whether influenza vaccination induced antibody mediated rejection in a large cohort of solid organ transplant recipients (SOTR). Serum anti-Human Leukocyte Antigen (HLA) antibodies were determined using class I and class II antibody-coated latex beads (FlowPRATM Screening Test) by flow cytometry. Anti-HLA antibody specificity was determined using the single-antigen bead flow cytometry (SAFC) assay and assignation of donor specific antibodies (DSA) was performed by virtual-crossmatch. We studied a cohort of 490 SOTR that received an influenza vaccination from 2009 to 2013: 110 (22.4%) received the pandemic adjuvanted vaccine, 59 (12%) within the first 6 months post-transplantation, 185 (37.7%) more than 6 months after transplantation and 136 (27.7%) received two vaccination doses. Overall, no differences of anti-HLA antibodies were found after immunization in patients that received the adjuvanted vaccine, within the first 6 months post-transplantation, or based on the type of organ transplanted. However, the second immunization dose increased the percentage of patients positive for anti-HLA class I significantly compared with patients with one dose (14.6% vs. 3.8%; P = 0.003). Patients with pre-existing antibodies before vaccination (15.7% for anti-HLA class I and 15.9% for class II) did not increase reactivity after immunization. A group of 75 (14.4%) patients developed de novo anti-HLA antibodies, however, only 5 (1.02%) of them were DSA, and none experienced allograft rejection. Only two (0.4%) patients were diagnosed with graft rejection with favorable outcomes and neither of them developed DSA. Our results suggest that influenza vaccination is not associated with graft rejection in this cohort of SOTR.

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Biomarkers
Female
Flow cytometry
Graft rejection
HLA antigens
Histocompatibility
Histocompatibility testing
Humans
Influenza vaccines
Isoantibodies
Longitudinal studies
Male
Middle aged
Organ transplantation
Prospective studies
Risk assessment
Risk factors
Spain
Time factors
Treatment outcome
Vaccination

DeCS Terms

Antígenos HLA
Citometría de flujo
Histocompatibilidad
Prueba de histocompatibilidad
Rechazo de injerto
Resultado del tratamiento
Trasplante de órganos
Vacunación

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Keywords

Alloreactivity, Anti-human leukocyte antigen, Cytomegalovirus, Donor specific antibodies, Organ rejection

Citation

Cordero E, Bulnes-Ramos A, Aguilar-Guisado M, González Escribano F, Olivas I, Torre-Cisneros J, et al. Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients. Front Immunol. 2020 Oct 6;11:1917