We would like to share ideas on the article “Antibody Response to Severe Acute Respiratory Disease Coronavirus 2 Messenger RNA Vaccines in Liver Transplant Recipients” by Strauss et al.⁽¹⁾ In this article, the authors include this statement: “Because LT recipients often receive milder induction and maintenance immunosuppression, they may have a more robust humoral response.”⁽¹⁾ At present, there are many reports on vaccination for transplant recipients and some reports on extraordinary vaccination regimens, such as multiple dose regimens.⁽²⁾ A consideration of the ethical issues regarding vaccination is very important.⁽³⁾ The present report is a good example of an ethical observational study on vaccination in transplant recipients. However, the method for measurement of antibody response should be discussed. Severe acute respiratory disease coronavirus 2 spike protein immunoassays might not reflect prevention. Hence, any conclusions regarding low immune response should be cautious. Also, the sensitivity of diagnostic tests should be discussed. Whether there is any interference effect from abnormal liver function (such as low protein and high bilirubin) is an interesting question that needs study.

我们想分享关于 Strauss 等人的文章“肝脏移植受者中严重急性呼吸道疾病冠状病毒 2 信使 RNA 疫苗的抗体反应”的想法。^{( 1 )}在这篇文章中，作者包含了这样的声明：“因为 LT 接受者通常接受较温和的诱导和维持免疫抑制，他们可能有更强烈的体液反应。” ^{( 1 )}目前，移植受者接种疫苗的报道较多，也有一些关于特殊接种方案的报道，如多剂量方案。^{( 2 )}关于疫苗接种的伦理问题的考虑是非常重要的。^{( 3 )}本报告是移植受者疫苗接种伦理观察研究的一个很好的例子。然而，应该讨论测量抗体反应的方法。严重急性呼吸道疾病冠状病毒 2 刺突蛋白免疫测定可能无法反映预防。因此，任何关于低免疫反应的结论都应谨慎。此外，还应讨论诊断测试的敏感性。肝功能异常（如低蛋白、高胆红素）是否有干扰作用，是一个值得研究的有趣问题。