COVID-19 infection and vaccination rarely impact HLA antibody profile in waitlisted renal transplant candidates- a multicenter cohort

Garrett R. Roll, Robert A. Bray, Matthew Cooper, Todd N. Eagar, Howard M. Gebel, Gayle M. Vranic, Kelley M.K. Hitchman, Julie Houp, Malek Kamoun, John Killian, Jim Kim, Vineeta Kumar, Matthew Levine, Brendan P. Lovasik, Tyler Lunow-Luke, Ronald F. Parsons, Vikram Pattanayak, Daniel Ranch, Anushi Shah, Peter G. StockOlga A. Timofeeva, Jennifer Trofe-Clark, Chelsey Wongjirad, Heidi Yeh, Stephanie Yi, Raja Rajalingam

Research output: Contribution to journalArticlepeer-review


Although rare, infection and vaccination can result in antibodies to human leukocyte antigens (HLA). We analyzed the effect of SARS-CoV-2 infection or vaccination on HLA antibodies in waitlisted renal transplant candidates. Specificities were collected and adjudicated if the calculated panel reactive antibodies (cPRA) changed after exposure. Of 409 patients, 285 (69.7 %) had an initial cPRA of 0 %, and 56 (13.7 %) had an initial cPRA > 80 %. The cPRA changed in 26 patients (6.4 %), 16 (3.9 %) increased, and 10 (2.4 %) decreased. Based on cPRA adjudication, cPRA differences generally resulted from a small number of specificities with subtle fluctuations around the borderline of the participating centers’ cutoff for unacceptable antigen listing. All five COVID recovered patients with an increased cPRA were female (p = 0.02). In summary, exposure to this virus or vaccine does not increase HLA antibody specificities and their MFI in approximately 99 % of cases and 97 % of sensitized patients. These results have implications for virtual crossmatching at the time of organ offer after SARS-CoV-2 infection or vaccination, and these events of unclear clinical significance should not influence vaccination programs.

Original languageEnglish (US)
Pages (from-to)278-285
Number of pages8
JournalHuman Immunology
Issue number4
StatePublished - Apr 2023


  • COVID-19 vaccination
  • Kidney transplantation
  • Organ allocation
  • SARS-CoV-2 infection
  • Virtual crossmatch
  • Humans
  • Vaccination
  • Antibodies
  • Male
  • Isoantibodies
  • Kidney Transplantation/methods
  • COVID-19
  • SARS-CoV-2
  • Female
  • Histocompatibility Testing/methods
  • Tissue Donors
  • HLA Antigens

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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