Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study

Abstract Liver transplant (LTx) recipients risk severe COVID-19. Vaccination reduces this risk. However, there may be side effects, including elevated alanine transaminase (ALT) which could lead to increased use of liver biopsy. We aimed to describe prevalence and relative incidence of elevated ALT...

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Main Authors: Jacob Siewertsen Bergmann, Sebastian Rask Hamm, Louise Bering, Christian Ross Pedersen, Ask Bock, Safura-Luise Heidari, Gerda Elisabeth Villadsen, Annette Dam Fialla, Gro Linno Willemoe, Peter Holland-Fischer, Susanne Dam Nielsen
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:npj Vaccines
Online Access:https://doi.org/10.1038/s41541-025-01233-7
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author Jacob Siewertsen Bergmann
Sebastian Rask Hamm
Louise Bering
Christian Ross Pedersen
Ask Bock
Safura-Luise Heidari
Gerda Elisabeth Villadsen
Annette Dam Fialla
Gro Linno Willemoe
Peter Holland-Fischer
Susanne Dam Nielsen
author_facet Jacob Siewertsen Bergmann
Sebastian Rask Hamm
Louise Bering
Christian Ross Pedersen
Ask Bock
Safura-Luise Heidari
Gerda Elisabeth Villadsen
Annette Dam Fialla
Gro Linno Willemoe
Peter Holland-Fischer
Susanne Dam Nielsen
author_sort Jacob Siewertsen Bergmann
collection DOAJ
description Abstract Liver transplant (LTx) recipients risk severe COVID-19. Vaccination reduces this risk. However, there may be side effects, including elevated alanine transaminase (ALT) which could lead to increased use of liver biopsy. We aimed to describe prevalence and relative incidence of elevated ALT 90 days before and after BNT162b2 vaccination in LTx recipients. Furthermore, we aimed to describe changes in prevalence of liver biopsies before and after BNT162b2 vaccination. We included 393 LTx recipients from The Danish Comorbidity in Liver Transplant Recipients (DACOLT) study. We calculated prevalence of elevated ALT and liver biopsies before and after each BNT162b2 vaccine dose. We used self-control case series (SCCS) analysis to investigate whether vaccination was associated with higher relative incidence of elevated ALT. Prevalence of elevated ALT, around each vaccine dose, was comparable. We did not find higher relative incidence of elevated ALT after vaccination. The prevalence of liver biopsies around vaccination was comparable.
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spelling doaj-art-7cc21b36bb5142cf9cd1e83a945b79c62025-08-20T03:45:40ZengNature Portfolionpj Vaccines2059-01052025-08-011011810.1038/s41541-025-01233-7Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort studyJacob Siewertsen Bergmann0Sebastian Rask Hamm1Louise Bering2Christian Ross Pedersen3Ask Bock4Safura-Luise Heidari5Gerda Elisabeth Villadsen6Annette Dam Fialla7Gro Linno Willemoe8Peter Holland-Fischer9Susanne Dam Nielsen10Viro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletViro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletViro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletDepartment of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital - RigshospitaletViro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletViro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletDepartment of Hepatology and Gastroenterology, Aarhus University HospitalDepartment of Gastroenterology and Hepatology, Odense University HospitalDepartment of Pathology, Rigshospitalet, Copenhagen University HospitalDepartment of Gastroenterology, Aalborg University HospitalViro-Immunology Research Unit, Department of Infectious Diseases, Copenhagen University Hospital - RigshospitaletAbstract Liver transplant (LTx) recipients risk severe COVID-19. Vaccination reduces this risk. However, there may be side effects, including elevated alanine transaminase (ALT) which could lead to increased use of liver biopsy. We aimed to describe prevalence and relative incidence of elevated ALT 90 days before and after BNT162b2 vaccination in LTx recipients. Furthermore, we aimed to describe changes in prevalence of liver biopsies before and after BNT162b2 vaccination. We included 393 LTx recipients from The Danish Comorbidity in Liver Transplant Recipients (DACOLT) study. We calculated prevalence of elevated ALT and liver biopsies before and after each BNT162b2 vaccine dose. We used self-control case series (SCCS) analysis to investigate whether vaccination was associated with higher relative incidence of elevated ALT. Prevalence of elevated ALT, around each vaccine dose, was comparable. We did not find higher relative incidence of elevated ALT after vaccination. The prevalence of liver biopsies around vaccination was comparable.https://doi.org/10.1038/s41541-025-01233-7
spellingShingle Jacob Siewertsen Bergmann
Sebastian Rask Hamm
Louise Bering
Christian Ross Pedersen
Ask Bock
Safura-Luise Heidari
Gerda Elisabeth Villadsen
Annette Dam Fialla
Gro Linno Willemoe
Peter Holland-Fischer
Susanne Dam Nielsen
Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
npj Vaccines
title Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
title_full Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
title_fullStr Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
title_full_unstemmed Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
title_short Elevated alanine transaminase in liver transplant recipients after BNT162b2 vaccination: a cohort study
title_sort elevated alanine transaminase in liver transplant recipients after bnt162b2 vaccination a cohort study
url https://doi.org/10.1038/s41541-025-01233-7
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