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Although it is known that vaccination influences anti\u2010pig antibody production, the specific effects of COVID\u201019 vaccines, particularly inactivated forms, remain underexplored. We analyzed serum samples from healthy individuals, patients with end\u2010stage liver disease (ESLD), and liver transplant (LT) recipients to assess antibody binding to TKO pig cells. Our findings reveal a significant difference in anti\u2010TKO pig antibody levels among healthy controls, ESLD patients, and LT recipients. A positive correlation was observed between SARS\u2010CoV\u20102 IgG and anti\u2010TKO pig IgG levels in ESLD patients. Additionally, LT recipients with active COVID\u201019 infection showed significantly higher levels of anti\u2010TKO pig IgG antibodies. These results suggest that both inactivated COVID\u201019 vaccination and infection may potentially increase anti\u2010TKO pig antibody production. This underscores the importance of closely monitoring anti\u2010pig antibody levels in potential xenotransplant recipients following COVID\u201019 vaccination or infection, highlighting the need for further research to optimize xenotransplantation protocols in the post\u2010pandemic era.<\/jats:p>","DOI":"10.1111\/xen.70050","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T02:14:40Z","timestamp":1747361680000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of COVID\u201019 Vaccination and Infection on Anti\u2010Triple\u2010Knockout (TKO) Pig Antibody Production: A Study in Patients With End\u2010Stage Liver Disease and Liver Transplant Recipients"],"prefix":"10.1111","volume":"32","author":[{"given":"Liaoran","family":"Wang","sequence":"first","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Zhejiang University School of Medicine Hangzhou China"},{"name":"NHC Key Laboratory of Combined Multi\u2010organ Transplantation Institute of Organ Transplantation Zhejiang University Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery Shulan (Hangzhou) Hospital Zhejiang Shuren University School of Medicine Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"The Transplantation Institute of the Second Affiliated Hospital Hainan Medical University Hainan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Hara","sequence":"additional","affiliation":[{"name":"The Transplantation Institute of the Second Affiliated Hospital Hainan Medical University Hainan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David K. 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