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Active and Passive Immunization Approaches in Transplant Recipients

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Abstract

Purpose of Review

The COVID-19 pandemic has greatly impacted solid organ transplant recipients (SOTr). Strategies to improve outcomes in this population include active immunization through vaccination and passive immunity through monoclonal antibodies and convalescent plasma. Unfortunately, the response to vaccination is greatly impacted by immunosuppression in SOTr, and monoclonal antibodies are no longer effective against circulating variants.

Recent Findings

This review summarizes the decreased immune response to vaccination in SOTr and the clinical efficacy of vaccination. Strategies to bolster immune response to vaccination include administration of booster doses, immunomodulation, timing of vaccination, type and dose of vaccine, and use of adjuvants. In addition to active immunization, we briefly describe passive immunization strategies that have a role in SARS-CoV2 prevention.

Summary

Active and passive immunization is vital in reducing poor outcomes, including hospitalization and mortality, in SOTr. Further studies on optimization of immune response to SARS-CoV2 vaccine are needed.

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Data Availability

The authors confirms that all data analyzed during this study are publicly available at the time of submission.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. NYU Grossman School of Medicine, New York, NY, USA

    Matthew Ringer

  2. NYU Langone Transplant Institute, New York, NY, USA

    Matthew Ringer

  3. Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA

    Marwan M. Azar & Maricar Malinis

  4. Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA

    Marwan M. Azar

  5. Department of Surgery, Yale School of Medicine, New Haven, CT, USA

    Maricar Malinis

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Conceptualization was performed by MR, MA, and MM. Literature search and data analysis were performed by MR and MM. Draft was performed by MR. Critical revision of the work was performed by MR, MA, and MM.

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Correspondence to Maricar Malinis.

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Maricar Malinis served as an Advisory Board Member for Takeda and a primary investigator at Yale Site of clinical trials sponsored by Takeda and Aicuris.

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Ringer, M., Azar, M.M. & Malinis, M. Active and Passive Immunization Approaches in Transplant Recipients. Curr Transpl Rep 10, 188–198 (2023). https://doi.org/10.1007/s40472-023-00406-4

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