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Korean J Transplant . Acute T cell-mediated rejection after administration of the BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient:

tetano

Editor, Senior Moderator
Korean J Transplant


. 2021 Dec 31;35(4):253-256.
doi: 10.4285/kjt.21.0025.
Acute T cell-mediated rejection after administration of the BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient: a case report


Hye-Won Jang[SUP] 1 [/SUP], Seongman Bae[SUP] 2 [/SUP], Youngmin Ko[SUP] 1 [/SUP], Seong Jun Lim[SUP] 1 [/SUP], Hye Eun Kwon[SUP] 1 [/SUP], Joo Hee Jung[SUP] 1 [/SUP], Hae Yon Cho[SUP] 3 [/SUP], Heounjeong Go[SUP] 3 [/SUP], Hyunwook Kwon[SUP] 1 [/SUP], Young Hoon Kim[SUP] 1 [/SUP], Sung-Han Kim[SUP] 2 [/SUP], Sung Shin[SUP] 1 [/SUP]



Affiliations

Abstract

The impact of the coronavirus disease 2019 (COVID-19) vaccination on humoral and cellular immunity in transplant recipients remains unknown. We report the case of a 78-year-old kidney transplant recipient who experienced acute T cell-mediated rejection after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). She had no history of acute rejection throughout the 13 years after deceased donor kidney transplantation. Fifteen days after receiving the second dose of the BNT162b2 vaccine, the recipient visited our center with a mild headache and fever. Her serum creatinine level had increased from 0.61 to 4.95 mg/dL. Kidney allograft biopsy indicated acute T cell-mediated rejection (grade IB) with no pathologic evidence of antibody-mediated rejection. Anti-severe acute respiratory syndrome coronavirus 2 spike-immunoglobulin G and -immunoglobulin M measurements were weak positive and negative, respectively. Careful monitoring of kidney allograft function is vital for transplant recipients undergoing COVID-19 vaccination.

Keywords: Acute T cell-mediated rejection; COVID-19 vaccination; Case report; Kidney transplant.
 
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