Jakob Joachim Spencker, Michael Mikhailov, Friederike Bachmann, Mira Choi, Wiebke Duettmann, Georgios Eleftheriadis, Fabian Halleck, Marcel G Naik, Eva Schrezenmeier, Bianca Zukunft, Klemens Budde, Bilgin Osmanodja
{"title":"肾移植受者接受替沙昔单抗/西加维单抗暴露前预防的COVID-19结局：一项单中心回顾性研究","authors":"Jakob Joachim Spencker, Michael Mikhailov, Friederike Bachmann, Mira Choi, Wiebke Duettmann, Georgios Eleftheriadis, Fabian Halleck, Marcel G Naik, Eva Schrezenmeier, Bianca Zukunft, Klemens Budde, Bilgin Osmanodja","doi":"10.1016/j.transproceed.2025.06.021","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Kidney transplant recipients (KTRs) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. For patients without serological response to COVID-19 vaccination, pre-exposure prophylaxis with tixagevimab/cilgavimab is an option to achieve alternative immunization.</p><p><strong>Methods: </strong>We retrospectively analyzed COVID-19 incidence and outcomes in a single-center cohort of 104 KTRs who received tixagevimab/cilgavimab pre-exposure prophylaxis between March 16, 2022, and January 18, 2023, comparing them with 36 unvaccinated and 224 vaccinated KTRs without pre-exposure prophylaxis infected during the Omicron era.</p><p><strong>Results: </strong>During a median follow-up time of 7.4 months (IQR, 5.9-10.1 months) after pre-exposure prophylaxis, 36 KTRs (35%) experienced breakthrough SARS-CoV-2 infections, with 5 (5%) having recurrent infections. Among those with breakthrough infection, 4 (11%) were hospitalized, and 1 (3%) died from COVID-19. No serious adverse events have followed tixagevimab/cilgavimab administration. In comparison, unvaccinated KTRs had a 51.0% hospitalization rate and an 8.6% mortality rate, and vaccinated patients without pre-exposure prophylaxis had a 17.0% hospitalization rate and a 2.2% mortality rate.</p><p><strong>Conclusion: </strong>These real-world data show that pre-exposure prophylaxis with tixagevimab/cilgavimab was a feasible alternative for patients without sufficient serological response to vaccination during a period of Omicron dominance. Novel therapeutics are necessary for variants resistant to tixagevimab/cilgavimab.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COVID-19 Outcomes in Kidney Transplant Recipients Receiving Tixagevimab/Cilgavimab for Pre-exposure Prophylaxis: A Single-center Retrospective Study.\",\"authors\":\"Jakob Joachim Spencker, Michael Mikhailov, Friederike Bachmann, Mira Choi, Wiebke Duettmann, Georgios Eleftheriadis, Fabian Halleck, Marcel G Naik, Eva Schrezenmeier, Bianca Zukunft, Klemens Budde, Bilgin Osmanodja\",\"doi\":\"10.1016/j.transproceed.2025.06.021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>Kidney transplant recipients (KTRs) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. For patients without serological response to COVID-19 vaccination, pre-exposure prophylaxis with tixagevimab/cilgavimab is an option to achieve alternative immunization.</p><p><strong>Methods: </strong>We retrospectively analyzed COVID-19 incidence and outcomes in a single-center cohort of 104 KTRs who received tixagevimab/cilgavimab pre-exposure prophylaxis between March 16, 2022, and January 18, 2023, comparing them with 36 unvaccinated and 224 vaccinated KTRs without pre-exposure prophylaxis infected during the Omicron era.</p><p><strong>Results: </strong>During a median follow-up time of 7.4 months (IQR, 5.9-10.1 months) after pre-exposure prophylaxis, 36 KTRs (35%) experienced breakthrough SARS-CoV-2 infections, with 5 (5%) having recurrent infections. Among those with breakthrough infection, 4 (11%) were hospitalized, and 1 (3%) died from COVID-19. No serious adverse events have followed tixagevimab/cilgavimab administration. In comparison, unvaccinated KTRs had a 51.0% hospitalization rate and an 8.6% mortality rate, and vaccinated patients without pre-exposure prophylaxis had a 17.0% hospitalization rate and a 2.2% mortality rate.</p><p><strong>Conclusion: </strong>These real-world data show that pre-exposure prophylaxis with tixagevimab/cilgavimab was a feasible alternative for patients without sufficient serological response to vaccination during a period of Omicron dominance. Novel therapeutics are necessary for variants resistant to tixagevimab/cilgavimab.</p>\",\"PeriodicalId\":94258,\"journal\":{\"name\":\"Transplantation proceedings\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation proceedings\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.transproceed.2025.06.021\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.transproceed.2025.06.021","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
COVID-19 Outcomes in Kidney Transplant Recipients Receiving Tixagevimab/Cilgavimab for Pre-exposure Prophylaxis: A Single-center Retrospective Study.
Background/aim: Kidney transplant recipients (KTRs) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. For patients without serological response to COVID-19 vaccination, pre-exposure prophylaxis with tixagevimab/cilgavimab is an option to achieve alternative immunization.
Methods: We retrospectively analyzed COVID-19 incidence and outcomes in a single-center cohort of 104 KTRs who received tixagevimab/cilgavimab pre-exposure prophylaxis between March 16, 2022, and January 18, 2023, comparing them with 36 unvaccinated and 224 vaccinated KTRs without pre-exposure prophylaxis infected during the Omicron era.
Results: During a median follow-up time of 7.4 months (IQR, 5.9-10.1 months) after pre-exposure prophylaxis, 36 KTRs (35%) experienced breakthrough SARS-CoV-2 infections, with 5 (5%) having recurrent infections. Among those with breakthrough infection, 4 (11%) were hospitalized, and 1 (3%) died from COVID-19. No serious adverse events have followed tixagevimab/cilgavimab administration. In comparison, unvaccinated KTRs had a 51.0% hospitalization rate and an 8.6% mortality rate, and vaccinated patients without pre-exposure prophylaxis had a 17.0% hospitalization rate and a 2.2% mortality rate.
Conclusion: These real-world data show that pre-exposure prophylaxis with tixagevimab/cilgavimab was a feasible alternative for patients without sufficient serological response to vaccination during a period of Omicron dominance. Novel therapeutics are necessary for variants resistant to tixagevimab/cilgavimab.
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