Transplant Trial Watch

Enhanced Humoral Immune Response After COVID-19 Vaccination in Elderly Kidney Transplant Recipients on Everolimus Versus Mycophenolate Mofetil-containing Immunosuppressive Regimens.

de Boer, S. E., et al.

Transplantation 2022 [record in progress].

The aim of this substudy of the OPTIMIZE trial was to investigate whether elderly kidney transplant recipients (KTRs) on an immunosuppressive treatment without mycophenolate mofetil (MMF) but including everolimus (EVR) have a better seroresponse after COVID- 19 mRNA vaccination compared to KTRs on MMF-containing immunosuppressive treatment.

Participants in the OPTMIZE trial were randomised to either the EVR group or the MMF group.

32 elderly kidney transplant recipients from the OPTIMIZE trial.

The main outcomes of interest were humoral response after the 2nd and 3rd vaccinations, and cellular response after the 2nd vaccination.

Median 40 days after second vaccination and 61 days after third vaccination.

CET Conclusions
This small, single-centre report of the Dutch multicentre OPTIMIZE trial compared two immunosuppressive regimens, i.e. standard-exposure calcineurin inhibitor (CNI), mycophenolate mofetil, and prednisolone (MMF group) versus low dose CNI, everolimus, and prednisolone (everolimus group) in elderly kidney transplant recipients (n=32). The report describes both the humoral and cellular response. The seroconversion rate was significantly higher in the everolimus group after 2 and 3 vaccinations. There was no differences between groups in the cellular response measured after 2 vaccinations. The authors suggest that the effect of everolimus on the vaccination response should be investigated in larger studies, including in kidney transplant recipients of all ages.

Jadad score

Data analysis
Per protocol analysis

Allocation concealment

Trial registration - NCT03797196

Funding source
No funding received