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Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination

Tobias Laue1,2, Maria Pilar Ballester3, Lily Meoli4

  • 1Department of Paediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Transplantation Direct
|May 1, 2025
PubMed

Insights

Pediatric solid organ transplant recipients (SOTRs) show a stronger serological response to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccines compared to adults. This supports the efficacy and safety of COVID-19 vaccination in pediatric SOTRs.

Area of Science:

  • Immunology
  • Transplantation
  • Vaccinology

Background:

  • Adult solid organ transplant recipients (SOTRs) exhibit diminished responses to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccines and increased infection rates.
  • Limited data exist on the serological response to SARS-CoV-2 vaccination in pediatric SOTRs.

Purpose of the Study:

  • To assess the serological response to SARS-CoV-2 vaccination in pediatric liver (LT) and kidney transplant (KT) recipients.
  • To compare these responses with those observed in adult SOTRs.

Main Methods:

  • A prospective, multicenter European study involving 42 pediatric (16 LT, 26 KT) and 117 adult (all LT) SOTRs.
  • Serological endpoints, specifically anti-Spike IgG levels, were measured using ELISA at 7 and 32 weeks post-vaccination.
  • Most participants received mRNA vaccines.

Main Results:

  • Pediatric SOTRs demonstrated significantly higher anti-Spike IgG levels at both 7 and 32 weeks compared to adult SOTRs (P < 0.0001 at week 7, P = 0.0032 at week 32).
  • No significant difference in anti-Spike IgG response was observed between pediatric LT and KT recipients at week 7 (P = 0.9854).
  • The rate of anti-Spike IgG decline between weeks 7 and 32 did not differ significantly between pediatric and adult SOTRs (P = 0.8000).
  • Lower anti-Spike IgG levels at week 7 in pediatric SOTRs were associated with male sex and specific kidney conditions (hemolytic-uremic syndrome or postischemic kidney disease).

Conclusions:

  • Pediatric SOTRs exhibit a more robust serological response to SARS-CoV-2 vaccination than adult SOTRs.
  • These findings support the efficacy and safety of SARS-CoV-2 vaccination in pediatric SOTRs.
  • The results may help reduce vaccine hesitancy among pediatric SOTR patients and their families.
Abstract

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