Acute kidney rejection after anti-SARS-CoV-2 virus-vectored vaccine—case report.

Vnučák, Matej; Graňák, Karol; Beliančinová, Monika; Jeseňák, Miloš; Macháleková, Katarína Kajová; Benko, Jakub; Samoš, Matej; Dedinská, Ivana

COVID-19 infection remains a threat to the health systems of many countries. Potential success in the fight against the COVID-19 pandemic is the vaccination of high-risk groups, including patients with end-stage kidney disease (ESKD) and after solid organ transplantation (SOT). Immunosuppression in kidney transplant recipients can also reduce the immunogenicity of SARS-CoV-2 vaccines (varied by vaccine platform), available data suggest that they are efficacious in approximately 50–70%, compared to non-transplant situations. In this paper, we present a newly developed acute humoral and cellular rejection with acute allograft failure and need of hemodialysis 14 days after administration of the adenovirus vectored SARS-CoV-2 vaccine (AstraZeneca; CHADOx1, AZD1222). This occurred in a patient who previously had an asymptomatic COVID-19 infection. Case reports of acute allograft rejection after vaccination against SARS-CoV-2 can help stratify risk groups of patients who develop hyperimmune reactions. However, it is also possible that those with a previous mild primary COVID-19 infection may also develop acute allograft rejections upon COVID-19 re-infection.

ASTRAZENECA PLC; COVID-19; GRAFT rejection; COVID-19 vaccines; KIDNEYS; CHRONIC kidney failure; KIDNEY transplantation; ADENOVIRUSES; BK virus

NPJ Vaccines, 2022, Vol 7, Issue 1, p1

2059-0105

Academic Journal

10.1038/s41541-022-00445-5