P16.41: Acute Kidney Rejection After Anti-sars-Cov-2 Virus-Vectored Vaccine – Case Report

COVID-19 infection remains a threat to the health systems of many countries. A potential success in the fight against the COVID-19 pandemic is the vaccination of high-risk groups, including patients with end-stage kidney disease (ESKD) and after solid organ transplantation (SOT). Immunosuppression in kidney transplant recipients can also reduce the immunogenicity of SARS-CoV-2 vaccines (varied by vaccine platform), available data suggest that they are efficacious in approximately 50 – 70 %, compared to non-transplant situations. In this paper, we present a newly developed acute humoral and cellular rejection with acute allograft failure and need of haemodialysis 14 days after administration of the adenovirus vectored SARS-CoV-2 vaccine (AstraZeneca; CHADOx1, AZD1222). This occurred in a patient who previously had an asymptomatic COVID-19 infection. Case reports of acute allograft rejection after vaccination against SARS-CoV-2 can help stratify risk groups of patients who develop hyperimmune reactions. However, it is also possible that those with a previous mild primary COVID-19 infection may also develop acute allograft rejections upon COVID-19 re-infection. Matej Vnučák: participated in writing the paper and collecting the data. Karol Graňák: participated in writing the paper and collecting the data. Monika Beliančinová participated in collecting the data. Miloš Jeseňák: participated in paper design. Katarína Kajová Macháleková: participated in collecting the data. Jakub Benko: participated in collecting the data. Matej Samoš: participated in paper design. Ivana Dedinská: participated in writing the paper.