Impact of COVID-19 Vaccination and Infection on Anti-Triple-Knockout (TKO) Pig Antibody Production: A Study in Patients With End-Stage Liver Disease and Liver Transplant Recipients.

This study investigates the impact of COVID-19 vaccination, with a focus on inactivated vaccines, on the production of anti-triple-knockout (TKO) pig antibodies, crucial for xenotransplantation. Although it is known that vaccination influences anti-pig antibody production, the specific effects of COVID-19 vaccines, particularly inactivated forms, remain underexplored. We analyzed serum samples from healthy individuals, patients with end-stage liver disease (ESLD), and liver transplant (LT) recipients to assess antibody binding to TKO pig cells. Our findings reveal a significant difference in anti-TKO pig antibody levels among healthy controls, ESLD patients, and LT recipients. A positive correlation was observed between SARS-CoV-2 IgG and anti-TKO pig IgG levels in ESLD patients. Additionally, LT recipients with active COVID-19 infection showed significantly higher levels of anti-TKO pig IgG antibodies. These results suggest that both inactivated COVID-19 vaccination and infection may potentially increase anti-TKO pig antibody production. This underscores the importance of closely monitoring anti-pig antibody levels in potential xenotransplant recipients following COVID-19 vaccination or infection, highlighting the need for further research to optimize xenotransplantation protocols in the post-pandemic era.