AUTHOR=Bachmann Friederike , Budde Klemens , Suttorp Norbert , Lingscheid Tilman , Stegemann Miriam Songa , Osmanodja Bilgin , Schrezenmeier Eva , Duettmann Wiebke , Weber Ulrike , Naik Marcel , Lehner Lukas Johannes , Kahl Andreas , Duerr Michael , Eckardt Kai-Uwe , Waiser Johannes , Choi Mira , Halleck Fabian
TITLE=Initial Experience With SARS-CoV-2-Neutralizing Monoclonal Antibodies in Kidney or Combined Kidney-Pancreas Transplant Recipients
JOURNAL=Transplant International
VOLUME=35
YEAR=2022
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10109
DOI=10.3389/ti.2022.10109
ISSN=1432-2277
ABSTRACT=Background: Antiviral drugs have shown little impact in patient infected with acute respiratory coronavirus 2 (SARS-CoV-2). Especially for immunocompromised persons positive for SARS-CoV-2, novel treatments are warranted. Recently, the U.S. FDA has granted an emergency use authorization (EUA) to two monoclonal antibodies (mAb) targeting the viral spike protein: bamlanivimab and casivirimab and imdevimab. As per the EUA, all SARS-CoV-2 positive organ transplant recipients can receive mAb treatment.
Patients and methods: We queried our center’s transplant registry to identify SARS-CoV-2 infected recipients treated with single doses of either Bamlanivimab or casivirimab/imdevimab up to May 31, 2021. We analyzed clinical outcomes, renal function and virus-specific antibodies. The co-primary endpoints were hospitalization due to COVID-19 and SARS-CoV-2 RT-PCR negativity.
Results: Thirteen patients at a median interval of 55 (IQR, 26-110) months from transplant were treated: 8 with bamlanivimab and 5 with casivirimab/imdevimab. In all, 4/13 (31%) patients were hospitalized at some time, while 11/13 (85%) achieved PCR negativity. 2/4 hospitalized patients received mAb as rescue treatment. Overall mortality was 23%, with one death attributable to transplant-associated lymphoma. All six patients infected with the B 1.1.7 variant were alive at last contact. Conclusion: mAb treatment appears effective when administered early to SARS-CoV-2-infected transplant recipients.