AUTHOR=Cordero Elisa , Bulnes-Ramos Angel , Aguilar-Guisado Manuela , González Escribano Francisca , Olivas Israel , Torre-Cisneros Julián , Gavaldá Joan , Aydillo Teresa , Moreno Asunción , Montejo Miguel , Fariñas María Carmen , Carratalá Jordi , Muñoz Patricia , Blanes Marino , Fortún Jesús , Suárez-Benjumea Alejandro , López-Medrano Francisco , Roca Cristina , Lara Rosario , Pérez-Romero Pilar 

TITLE=Effect of Influenza Vaccination Inducing Antibody Mediated Rejection in Solid Organ Transplant Recipients

JOURNAL=Frontiers in Immunology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.01917

DOI=10.3389/fimmu.2020.01917

ISSN=1664-3224

ABSTRACT=<sec><title>Introduction</title><p>Our goal was to study whether influenza vaccination induced antibody mediated rejection in a large cohort of solid organ transplant recipients (SOTR).</p></sec><sec><title>Methods</title><p>Serum anti-Human Leukocyte Antigen (HLA) antibodies were determined using class I and class II antibody-coated latex beads (FlowPRA<sup>TM</sup> Screening Test) by flow cytometry. Anti-HLA antibody specificity was determined using the single-antigen bead flow cytometry (SAFC) assay and assignation of donor specific antibodies (DSA) was performed by virtual-crossmatch.</p></sec><sec><title>Results</title><p>We studied a cohort of 490 SOTR that received an influenza vaccination from 2009 to 2013: 110 (22.4%) received the pandemic adjuvanted vaccine, 59 (12%) within the first 6 months post-transplantation, 185 (37.7%) more than 6 months after transplantation and 136 (27.7%) received two vaccination doses. Overall, no differences of anti-HLA antibodies were found after immunization in patients that received the adjuvanted vaccine, within the first 6 months post-transplantation, or based on the type of organ transplanted. However, the second immunization dose increased the percentage of patients positive for anti-HLA class I significantly compared with patients with one dose (14.6% vs. 3.8%; <italic>P</italic> = 0.003). Patients with pre-existing antibodies before vaccination (15.7% for anti-HLA class I and 15.9% for class II) did not increase reactivity after immunization. A group of 75 (14.4%) patients developed <italic>de novo</italic> anti-HLA antibodies, however, only 5 (1.02%) of them were DSA, and none experienced allograft rejection. Only two (0.4%) patients were diagnosed with graft rejection with favorable outcomes and neither of them developed DSA.</p></sec><sec><title>Conclusion</title><p>Our results suggest that influenza vaccination is not associated with graft rejection in this cohort of SOTR.</p></sec>