{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:16:02Z","timestamp":1787030162300,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,4]],"date-time":"2023-03-04T00:00:00Z","timestamp":1677888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chang-Gung Medical Foundation","award":["CORPG-3K0242"],"award-info":[{"award-number":["CORPG-3K0242"]}]},{"name":"Chang-Gung Medical Foundation","award":["CORPG-3L0481"],"award-info":[{"award-number":["CORPG-3L0481"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Liver transplant recipients are immunocompromised and have low immunogenicity to produce antibodies in anti-COVID-19 vaccination. Whether immunosuppressant adjustment could facilitate anti-COVID-19 antibody production in anti-COVID-19 mRNA vaccination is undetermined. Our patients were informed to temporarily suspend mycophenolate mofetil (MMF) or everolimus (EVR) for 2 weeks during both the 1st and 2nd doses of Moderna mRNA-1273 vaccine. A total of 183 recipients receiving two doses of Moderna mRNA-1273 vaccine were enrolled and grouped into tacrolimus monotherapy (MT, n = 41), and dual therapy with non-adjustment (NA, n = 23), single suspension (SS, n = 19) and double suspension (DS, n = 100) of MMF\/EVR in two-dose mRNA vaccination. A total of 155 (84.7%) patients had a humoral response to vaccines in this study. The humoral response rates were 60.9%, 89.5%, 91.0% and 80.5% in NA, SS, DS, and MT group patients, respectively (p = 0.003). Multivariate analysis showed that favorable factors for humoral response were temporary suspension of MMF\/EVR and monotherapy, and unfavorable factors were deceased donor liver transplantation, WBC count &lt; 4000\/uL, lymphocyte &lt; 20% and tacrolimus trough level \u2265 6.8 ng\/mL. In conclusion, temporary two-week suspension of anti-proliferation immunosuppressants could create a window to facilitate antibody production during anti-COVID-19 mRNA vaccination. This concept may be applied to other vaccinations in liver transplant recipients.<\/jats:p>","DOI":"10.3390\/v15030678","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T05:18:43Z","timestamp":1678079923000},"page":"678","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Adjustment of Immunosuppressants to Facilitate Anti-COVID-19 Antibody Production after mRNA Vaccination in Liver Transplant Recipients"],"prefix":"10.3390","volume":"15","author":[{"given":"Wei-Chen","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8830-3679","authenticated-orcid":false,"given":"Hao-Chien","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6075-8786","authenticated-orcid":false,"given":"Jin-Chiao","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0598-5684","authenticated-orcid":false,"given":"Chung-Guei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, Chang-Gung University College of Medicine, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Wen","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chao","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsien","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5083-8851","authenticated-orcid":false,"given":"Tsung-Han","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Fang","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8911-8758","authenticated-orcid":false,"given":"Ting-Jung","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3583-2048","authenticated-orcid":false,"given":"Hong-Shiue","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Ming","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Taoyuan 33357, Taiwan"},{"name":"Surgery, College of Medicine, Chang-Gung University, Taoyuan 33357, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1080\/14787210.2021.1863146","article-title":"An update on COVID-19 pandemic: The epidemiology, pathogenesis, prevention and treatment strategies","volume":"19","author":"Tsang","year":"2021","journal-title":"Expert Rev. 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