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World J Meta-Anal. Jun 18, 2024; 12(2): 91264
Published online Jun 18, 2024. doi: 10.13105/wjma.v12.i2.91264
Development of donor specific antibodies after SARS-CoV-2 vaccination: What do we know so far?
Ahmed Daoud, Karim Soliman, Maria Aurora Posadas Salas, Sakshi Vaishnav, Genta Uehara, Ahmed Abdelkader, Tibor Fulop, Michael J Casey
Ahmed Daoud, Karim Soliman, Maria Aurora Posadas Salas, Sakshi Vaishnav, Genta Uehara, Ahmed Abdelkader, Tibor Fulop, Michael J Casey, Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, United States
Ahmed Daoud, Department of Medicine, Cairo University Medical School, Cairo 11211, Egypt
Karim Soliman, Department of Medicine, Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC 29425, United States
Tibor Fulop, Department of Medicine, Division of Nephrology, Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC 29425, United States
Author contributions: Daoud A designed and performed the research; Soliman K, Posadas Salas MA, Vaishnav S, Uehara G, Abdelkader A, Fulop T, and Casey MJ wrote the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Daoud, MD, PhD, Doctor, Staff Physician, Department of Medicine, Division of Nephrology, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, United States. ahmed.daoud84@yahoo.com
Received: December 29, 2023
Revised: April 18, 2024
Accepted: June 7, 2024
Published online: June 18, 2024
Processing time: 167 Days and 23.7 Hours
Abstract

Vaccination against Coronavirus disease-19 (COVID-19) was pivotal to limit spread, morbidity and mortality. Our aim is to find out whether vaccines against COVID-19 lead to an immunological response stimulating the production of de novo donor specific antibodies (DSAs) or increase in mean fluorescence intensity (MFI) of pre-existing DSAs in kidney transplant recipients (KTRs). This study involved a detailed literature search through December 2nd, 2023 using PubMed as the primary database. The search strategy incorporated a combination of relevant Medical Subject Headings terms and keywords: "COVID-19", "SARS-CoV-2 Vaccination", "Kidney, Renal Transplant", and "Donor specific antibodies". The results from related studies were collated and analyzed. A total of 6 studies were identified, encompassing 460 KTRs vaccinated against COVID-19. Immunological responses were detected in 8 KTRs of which 5 had increased MFIs, 1 had de novo DSA, and 2 were categorized as either having de novo DSA or increased MFI. There were 48 KTRs with pre-existing DSAs prior to vaccination, but one study (Massa et al) did not report whether pre-existing DSAs were associated with post vaccination outcomes. Of the remaining 5 studies, 35 KTRs with pre-existing DSAs were identified of which 7 KTRs (20%) developed de novo DSAs or increased MFIs. Overall, no immunological response was detected in 452 (98.3%) KTRs. Our study affirms prior reports that COVID-19 vaccination is safe for KTRs, especially if there are no pre-existing DSAs. However, if KTRs have pre-existing DSAs, then an increased immunological risk may be present. These findings need to be taken cautiously as they are based on a limited number of patients so further studies are still needed for confirmation.

Keywords: COVID-19; SARS-CoV-2 vaccination; Kidney; Renal transplant; Donor specific antibodies

Core Tip: Our aim was to find out whether vaccines against Coronavirus disease 2019 (COVID-19) lead to an immunological response stimulating the production of de novo donor specific antibodies (DSAs) or increase in mean fluorescence intensity of pre-existing DSAs in kidney transplant recipients. We did a detailed literature search through December 2, 2023 using PubMed as the primary database. We used the following keywords: COVID-19, severe acute respiratory syndrome-coronavirus-2 vaccination, Kidney, Renal transplant, and DSAs. The results from related studies were collated and analyzed.