Acute Bilateral Descemet Membrane Endothelial Keratoplasty Graft Rejection After the BNT162b2 mRNA COVID-19 Vaccine

Forshaw, Thomas Richard Johansen; Jørgensen, Christel Thea; Kyhn, Maria Christiansen; Cabrerizo, Javier

doi:10.2147/imcrj.s362698

Cited by 8 publications

(11 citation statements)

References 6 publications

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“…A considerable number of solid organ rejections were observed following SARS-CoV-2 vaccination or COVID-19 infection. As the dominant organ rejection type following SARS-CoV-2 vaccination reported in our review, cornea allograft failure post-SARS-CoV-2 vaccines and COVID-19 infection has been increasingly well-documented in the literature during the preceding year penetrating keratoplasty or Descemet's membrane endothelial keratoplasty [7,10,15,56]. However, cornea transplantation is the oldest, most common and arguably the most successful form of solid tissue transplantation in the human body [62].…”

Section: Discussionmentioning

confidence: 99%

“…After the exclusion of duplicates and articles that did not fulfill the study inclusion criteria, fifty-two articles were included in the qualitative synthesis of this systematic review. The reports of ninety-six cases (fiftysix organ rejection cases following COVID-19 vaccination [7][8][9][10][11] and forty organ rejection cases after COVID-19 infection [12][13][14][15][16][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]) identified from these articles are presented in groups based on confirmed diagnoses, laboratory, biopsy and imaging findings. The detailed characteristics of the included studies are shown in Tables 1 and 2.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Cells in the anterior chamber There were 42 case reports [5][6][7][8][11][12][13]17,18,[20][21][22][24][25][26][27][29][30][31][32][33][34][35][37][38][39][40][41][42][43][44][45][48][49][50][51][52][53][54][55][56][57], 8 case series [9,10,14,28,36,46,47,58] and 2 cohort studies [19,23]. These studies were conducted in t...…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…These studies were conducted in the United States (n = 14), India (n = 7), Italy (n = 5), Canada (n = 4), United Kingdom (n = 3), France (n = 3), Brazil (n = 2), Lebanon (n = 2), Australia (n = 1), Greece (n = 1), Egypt (n = 1), Denmark (n = 1), Japan (n = 1), Israel (n = 1), South Korea (n = 1), Slovakia (n = 1), Croatia (n = 1), China (n = 1), Mexico (n = 1) and Sweden (n = 1). The majority of the studies were single centre [5][6][7][8][9][11][12][13]17,18,[20][21][22][48][49][50][51][52][53][54][55][56][57][58], and only six studies were multi-centre [10,14,19,23,46,47]. The median NOS score for these studies was 6 (range, 5-7).…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…A growing body of evidence has indicated that allograft rejections have occurred as a potential consequence of COVID-19 vaccines in cornea, liver and kidney transplant recipients [7][8][9][10][11]. Several cases of organ rejections following COVID-19 infection have been described among corneal and renal transplant recipients [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection is extremely rare but can occur. T-cell recognition of antigen is the primary and central event that leads to the cascade of events that result in rejection of a transplanted organ. Objectives: To describe the results of a systematic review for solid organ rejections following SARS-CoV-2 vaccination or COVID-19 infection. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines for studies on the incidence of solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection, published from 1 December 2019 to 31 May 2022, with English language restriction. Results: One hundred thirty-six cases from fifty-two articles were included in the qualitative synthesis of this systematic review (56 solid organs rejected post-SARS-CoV-2 vaccination and 40 solid organs rejected following COVID-19 infection). Cornea rejection (44 cases) was the most frequent organ observed post-SARS-CoV-2 vaccination and following COVID-19 infection, followed by kidney rejection (36 cases), liver rejection (12 cases), lung rejection (2 cases), heart rejection (1 case) and pancreas rejection (1 case). The median or mean patient age ranged from 23 to 94 years across the studies. The majority of the patients were male (n = 51, 53.1%) and were of White (Caucasian) (n = 51, 53.7%) and Hispanic (n = 15, 15.8%) ethnicity. A total of fifty-six solid organ rejections were reported post-SARS-CoV-2 vaccination [Pfizer-BioNTech (n = 31), Moderna (n = 14), Oxford Uni-AstraZeneca (n = 10) and Sinovac-CoronaVac (n = 1)]. The median time from SARS-CoV-2 vaccination to organ rejection was 13.5 h (IQR, 3.2–17.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5–21). Most patients were easily treated without any serious complications, recovered and did not require long-term allograft rejection therapy [graft success (n = 70, 85.4%), graft failure (n = 12, 14.6%), survived (n = 90, 95.7%) and died (n = 4, 4.3%)]. Conclusion: The reported evidence of solid organ rejections post-SARS-CoV-2 vaccination or COIVD-19 infection should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively small in relation to the hundreds of millions of vaccinations that have occurred, and the protective benefits offered by SARS-CoV-2 vaccination far outweigh the risks.

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Section: Discussionmentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

et al. 2022

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Tozinameran

2022

Reactions Weekly

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Vaccine-associated corneal graft rejection following SARS-CoV-2 vaccination: a CDC-VAERS database analysis

Singh

Parmar

et al. 2022

Br J Ophthalmol

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PurposeTo evaluate the cases of corneal graft rejection following SARS-CoV-2 vaccination reported to Centers for Disease Control and Prevention Vaccine Adverse Event Reporting System.MethodsA descriptive analysis of the demographics, clinical history and presentation was performed. We evaluated the correlation between the vaccines and duration of vaccine-associated graft rejection (VAR) onset following vaccination using a one-way analysis of variance test. A post hoc analysis was performed between VAR onset-interval following vaccination dose and vaccine type. Finally, a 30-day cumulative incidence analysis was performed to assess the risk of VAR in short term following different doses, vaccines and type of corneal transplantation.ResultsA total of 55 eyes of 46 patients were diagnosed with VAR following vaccination with BNT162b2 (73.91%) and mRNA-1273 (26.09%). The mean age of the patients was 62.76±15.83 years, and 28 (60.87%) were female. The patients diagnosed with VAR had undergone penetrating keratoplasty (61.82%), Descemet membrane endothelial keratoplasty (12.73%), descemet stripping endothelial keratoplasty (18.18%), anterior lamellar keratoplasty (3.64%) and corneal limbal allograft transplantation (1.82%). The mean time for VAR since penetrating and endothelial keratoplasty was 8.42±9.23 years and 4.18±4.40 years, respectively. 45.65% of the cases of VAR were reported after the second dose of vaccine. The duration of VAR onset was significantly shorter after the second dose compared with the first and booster doses (p=0.0165) and in patients who underwent endothelial keratoplasty compared with penetrating keratoplasty (p=0.041).ConclusionsThis study outlines a possible temporal relationship between corneal graft rejection and SARS-CoV-2 vaccination. An earlier onset of VAR was observed in patients who had a history of endothelial keratoplasty and following the second dose of vaccination.

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Acute Bilateral Descemet Membrane Endothelial Keratoplasty Graft Rejection After the BNT162b2 mRNA COVID-19 Vaccine

Cited by 8 publications

References 6 publications

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

Tozinameran

Vaccine-associated corneal graft rejection following SARS-CoV-2 vaccination: a CDC-VAERS database analysis

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