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Updated: Nov 3, 2025
In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients
Heather L Kutzler1,2, Hillary A Kuzaro1,2, Oscar K Serrano2
1Department of Pharmacy, Hartford Hospital, Hartford, CT, USA.
Abstract:
The widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to propagate the coronavirus disease 2019 (COVID-19) pandemic with solid organ transplant (SOT) recipients being an exceptionally vulnerable population for poor outcomes. Treatments for COVID-19 are limited; however, monoclonal antibodies are emerging as a potential therapeutic option to change the trajectory of high-risk patients. This retrospective single center cohort study evaluated the outcomes of SOT recipients with mild to moderate COVID-19 who received bamlanivimab monotherapy. Eighteen SOT recipients (15 kidney, 2 liver, and 1 heart) received the medication between November 9, 2020 and February 10, 2021 with no reported infusion reactions. One patient experienced headache and fatigue following the infusion that resolved within 3 days. Fourteen patients continued their recovery as an outpatient with no further escalation in care. Three patients required hospitalization: two for suspected bacterial pneumonia 9 and 32 days postinfusion, respectively, and one for acute kidney injury 7 days postinfusion. One patient had an emergency room visit for gastrointestinal symptoms 24 days postinfusion. In this small cohort of SOT recipients, bamlanivimab monotherapy appeared to be a well-tolerated option for treatment of mild to moderate COVID-19, but it was not completely effective in preventing hospitalization. One month following the end of this cohort, COVID-19 treatment guidance changed due to the rising prevalence of resistant variants. For this reason, bamlanivimab is now recommended to be used only in combination with etesevimab. Further studies are needed to fully elucidate the role of this therapy in SOT recipients.
Insights
Bamlanivimab monotherapy was a well-tolerated COVID-19 treatment for solid organ transplant recipients, but did not fully prevent hospitalizations. Current guidance recommends combination therapy due to variant resistance.
Area of Science:
- Immunology
- Infectious Diseases
- Transplant Medicine
Background:
- Solid organ transplant (SOT) recipients are highly vulnerable to severe outcomes from COVID-19.
- Limited effective treatments exist for COVID-19 in this immunocompromised population.
- Monoclonal antibodies offer a potential therapeutic avenue for high-risk patients.
Purpose of the Study:
- To evaluate the safety and effectiveness of bamlanivimab monotherapy in SOT recipients with mild to moderate COVID-19.
- To assess hospitalization rates and adverse events following bamlanivimab treatment in this cohort.
Main Methods:
- Retrospective single-center cohort study.
- Inclusion of 18 SOT recipients (15 kidney, 2 liver, 1 heart) treated with bamlanivimab.
- Monitoring for infusion reactions, hospitalizations, and other adverse events.
Main Results:
- Bamlanivimab was generally well-tolerated with no reported infusion reactions.
- Most patients (14/18) recovered as outpatients.
- Three patients required hospitalization for pneumonia or acute kidney injury; one had an ER visit for GI symptoms.
Conclusions:
- Bamlanivimab monotherapy appears safe for SOT recipients with mild to moderate COVID-19.
- It was not fully effective in preventing hospitalizations in this cohort.
- Evolving SARS-CoV-2 variants necessitate combination antibody therapies, like bamlanivimab with etesevimab.
