AUTHOR=Zong Kezhen , Peng Dadi , Yang Hang , Huang Zuotian , Luo Yunhai , Wang Yihua , Xiang Song , Li Tingting , Mou Tong , Wu Zhongjun 

TITLE=Risk Factors for Weak Antibody Response of SARS-CoV-2 Vaccine in Adult Solid Organ Transplant Recipients: A Systemic Review and Meta-Analysis

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.888385

DOI=10.3389/fimmu.2022.888385

ISSN=1664-3224

ABSTRACT=Objective: This is the first systematic review and meta-analysis to explore factors contributing to poor antibody response in organ transplant recipients after receiving the 2-dose SARS-CoV-2 vaccine.
Method: Embase, PubMed, Web of Science, Cochrane Library, CNKI, and CBM were explored for studies. Studies reporting factors associated with antibody responses to 2-dose SARS-CoV-2 vaccine in solid organ transplant recipients were included in our study according to inclusion and exclusion criteria. Two investigators completed a literature search, screening, and data extraction, respectively. Randomized models were used for synthesis. Egger's test was performed to evaluate publication bias. Sensitivity analysis was applied to examine the stability of the result. The heterogeneity was explored by the Galbraith plot and subgroup analysis.
Results: A total of 29 studies were included in the study. The factors including living donor, BNT162b2, tacrolimus, cyclosporine, antimetabolite, mycophenolic acid or mycophenolate mofetil, azathioprine, corticosteroids, high-dose corticosteroids, belatacept, mTOR inhibitor, tritherapy, age, eGFR, hemoglobin, and tacrolimus level are found significant differences. In the synthesis of the result of the multivariate analysis, significant differences are found in age, diabetes mellitus, mycophenolic acid or mycophenolate mofetil, high-dose corticosteroids, tritherapy, and eGFR.
Conclusion: Possible independent risk factors for negative antibody response in organ transplant patients with 2-dose SARS-CoV-2 vaccine include age, diabetes mellitus, low eGFR, mycophenolic acid or mycophenolate mofetil, high-dose corticosteroids, and triple immunosuppression therapy. And mTOR inhibitor may be the protective factor against weak antibody response.