Corneal allograft transplantation is the most frequently performed organ transplant procedure worldwide The cornea is one of the few organs with an immune privilege and, thus, a decreased rate of allograft rejection. However, in April 2021, two cases of acute corneal rejection after Descemet membrane endothelial keratoplasty (DMEK) with a possible association with COVID-19 vaccination were reported.
In addition, several reports have previously described corneal allograft rejection being triggered by vaccinations, including those secondary to Influenza and Hepatitis B vaccine administration. 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.
Thus, we must recognize the clinical features, risk factors, and course of allograft rejection, as well as currently known data on post-rejection rescue attempts. 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.
Thirteen articles reported four types of vaccines that were administered, including BNT162b2 (Pfizer/BioNTech, eight [38.1%] cases); mRNA-1273 (Moderna, eight [38.1%] cases); ChAdOx1 (University of Oxford/AstraZeneca, four [19.0%] cases); and CoronaVac (Sinovac Biotech, Beijing, China; one [4.8%] case). Approximately 66.7% of these patients received the first vaccine dose, whereas 33.3% received the second vaccine dose. So tally time: 21 corneal rejections with these 4 covid injections.
Among these cases, the interval between corneal transplantation and rejection ranged from 14 days to 25 years (median: 2 years. Someone had the corneal transplant be successful for TWENTY FIVE YEARS and then suddenly they went into rejection post vaccine??? The interval between COVID-19 vaccination and rejection ranged from 1 day to 6 weeks (mean, 10.4 days; median, 7 days). So rejection occurred SUPER fast after they were vaccinated, despite how many years they had post transplant.
How many people were required to GET the damn injection JUST TO QUALIFY FOR TRANSPLANT?!?!? So disgusting.
Two of these patients (two eyes) underwent transplant > 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.
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