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=Volume 35 - 2022

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: In subjects infected with the severe acute respiratory coronavirus 2 (SARS-CoV-2), treatment attempts with conventional antiviral drugs have largely failed. As immunocompromised persons having acquired SARS-CoV-2 are at high risk for adverse outcomes, novel strategies are highly warranted. Recently, the U.S. FDA has granted an emergency use authorization (EUA) to two monoclonal antibody (mAb) preparations targeting the viral spike protein: bamlanivimab (Bam) and casivirimab/imdevimab (CaI). As per the EUA, all solid organ transplant (SOT) recipients are eligible for mAb treatment once having tested positive for SARS-CoV-2. Patients and methods: We queried our center’s database to identify SARS-CoV-2 infected SOT recipients treated with either 700 mg Bam or 1,200 mg CaI up to May 31, 2021. Allocation to treatment was determined by availability of drugs. We analyzed clinical outcomes, renal function and SARS-CoV-2-specific antibodies. All initial samples were subjected to NGS-based sequencing of virus genomes. The co-primary endpoints were hospitalization due to COVID-19 and SARS-CoV-2 RT-PCR negativity. Results: 13 patients at a median interval of 55 (IQR, 26-110) months from SOT were treated: eight received Bam and 5 CaI. With three patients hospitalized at mAb therapy, only one further subject needed admission. Thus, 18% of patients reached the endpoint. 73% of treated SOT recipients are alive. Conclusion: mAb treatment appears effective when administered early to SARS-CoV-2-infected SOT patients.