Transplant recipients are rejecting their new organ after receiving a vaccination against COVID-19, adding an additional challenge for the vaccinated population, according to the new study published in the Journal of Clinical Medicine.
A group of 18 health experts and researchers from Japan conducted a study to systematically evaluate and characterize the currently reported cases of acute corneal graft rejection after COVID-19 vaccine administration.
A rejection graft occurs when the recipient’s immune system rejects tissue from a donor, in this case, the cornea.
The cornea is the transparent layer forming the front of the eye. Corneal allograft transplantation is the most frequently performed organ transplant procedure worldwide.
Compared to other organs, the cornea has a relatively low rate of allograft rejection due to its “immune privilege.” This fact prompted the researchers to examine the recent rise in corneal graft rejection following COVID vaccination.
“These reports have raised concerns among ophthalmologists as future booster doses of COVID-19 vaccines are being discussed, which may impact outcomes in future corneal allograft recipients,” the authors wrote.
“This information will help to establish effective care and preventive measures against allograft rejection in future corneal transplant recipients with a history of recent COVID-19 vaccination or for those planning COVID-19 vaccination.”
Japanese researchers compiled data from all articles published by 23 February 2022 using electronic bibliographic databases (PubMed and EMBASE).
Twenty-four articles were identified through the database search but only 13 articles met the inclusion criteria and were included in the systematic review.
“The articles included in this systematic review were published between 29 April 2021, and 23 December 2021. Nine articles were case reports, and four were case series. Four articles were from the United States of America; two each from the United Kingdom and India, and one each from Brazil, Greece, Israel, Lebanon, and Italy. A total of 21 patients (23 eyes) who experienced corneal graft rejection after COVID-19 vaccine administration were identified in the 13 studies,” the study stated.
According to the study, more than 95% of eyes (22/23 eyes) experienced corneal allograft rejection within 3 weeks of vaccination among the 21 patients (23 eyes).
The interval between vaccination and rejection ranged from 1 day to 6 weeks but some took the procedure as long as twenty years ago.
“In our analysis of 21 patients (23 eyes) with signs of corneal allograft rejection after receiving COVID-19 vaccines, the median interval between corneal transplantation and graft rejection after COVID-19 vaccination was 2 years. Two of these patients (two eyes) underwent PKP > 20 years ago and had no history of acute or chronic corneal allograft rejection. The long-term stability and temporariness of vaccination and allograft rejection suggest that immune responses to the vaccine may have played a role in transplant rejection,” the study stated.
Below is the list of patients’ information and vaccination status.
The study stated, “in conclusion, this systematic review identified clinical features and host factors associated with corneal allograft rejection after COVID-19 vaccination. As the virus continues to spread, additional booster COVID-19 vaccine schedules are expected. Therefore, proper follow-up of corneal allograft recipients and interventions to prevent corneal allograft rejection after administering the COVID-19 vaccine may be crucial.”
You can read and download the full study here.
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