A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications
Vaccine-induced thrombotic thrombocytopenia (VITT) has been recently linked with coronavirus disease (COVID-19) vaccines. It becomes crucial for the transplant communities to have a rigorous approach for accepting VITT donors, as the reports of such transplantation have been associated with thrombot...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=2;spage=169;epage=173;aulast=Kute |
| _version_ | 1797774293146271744 |
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| author | Vivek B Kute Sanshriti Chauhan Narayan Prasad Hari Shankar Meshram |
| author_facet | Vivek B Kute Sanshriti Chauhan Narayan Prasad Hari Shankar Meshram |
| author_sort | Vivek B Kute |
| collection | DOAJ |
| description | Vaccine-induced thrombotic thrombocytopenia (VITT) has been recently linked with coronavirus disease (COVID-19) vaccines. It becomes crucial for the transplant communities to have a rigorous approach for accepting VITT donors, as the reports of such transplantation have been associated with thrombotic complications, graft loss, and deaths. The magnitude of facing a VITT donor in transplantation practices is unknown and also the management protocol. However, as per the limited data, it is better to avoid such transplants, and in the case of emergency transplants, the risk-benefit ratio should be weighed. All transplantation from VITT donors should be appropriately counseled before procurement. The organs should undergo deliberate examination for functionality by clinical, laboratory, and radiological parameters. In doubtful cases, a preimplantation biopsy is mandated to rule out any thrombosis. VITT donors are suggested to be treated with newer oral anti-coagulation and intravenous immunoglobulin. Platelet transfusion is best avoided in a VITT donor. There is no established protocol for any modification in surgical procedure, anesthesia, or immunosuppressive medicines in the recipients. The recipients should undergo extensive clinical and laboratory monitoring for any possible complications. No prophylactic therapy is recommended at present but candidates with a history of any COVID-19 vaccine within 30 days, should be avoided. In summary, the evidence for diagnosis and management of VITT donors is based only on a few reports, but with current knowledge, it is advisable to take a multidisciplinary approach to assess all benefits and risks before accepting or discarding organs. |
| first_indexed | 2024-03-12T22:18:02Z |
| format | Article |
| id | doaj.art-8d2a29a21fca481c8f9bc526d3b3cec9 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-03-12T22:18:02Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-8d2a29a21fca481c8f9bc526d3b3cec92023-07-23T11:12:16ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252023-01-0117216917310.4103/ijot.ijot_12_22A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implicationsVivek B KuteSanshriti ChauhanNarayan PrasadHari Shankar MeshramVaccine-induced thrombotic thrombocytopenia (VITT) has been recently linked with coronavirus disease (COVID-19) vaccines. It becomes crucial for the transplant communities to have a rigorous approach for accepting VITT donors, as the reports of such transplantation have been associated with thrombotic complications, graft loss, and deaths. The magnitude of facing a VITT donor in transplantation practices is unknown and also the management protocol. However, as per the limited data, it is better to avoid such transplants, and in the case of emergency transplants, the risk-benefit ratio should be weighed. All transplantation from VITT donors should be appropriately counseled before procurement. The organs should undergo deliberate examination for functionality by clinical, laboratory, and radiological parameters. In doubtful cases, a preimplantation biopsy is mandated to rule out any thrombosis. VITT donors are suggested to be treated with newer oral anti-coagulation and intravenous immunoglobulin. Platelet transfusion is best avoided in a VITT donor. There is no established protocol for any modification in surgical procedure, anesthesia, or immunosuppressive medicines in the recipients. The recipients should undergo extensive clinical and laboratory monitoring for any possible complications. No prophylactic therapy is recommended at present but candidates with a history of any COVID-19 vaccine within 30 days, should be avoided. In summary, the evidence for diagnosis and management of VITT donors is based only on a few reports, but with current knowledge, it is advisable to take a multidisciplinary approach to assess all benefits and risks before accepting or discarding organs.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=2;spage=169;epage=173;aulast=Kutedeceased donationdisseminated intravascular coagulationorgan transplantationpreimplantation biopsysevere acute respiratory syndrome coronavirus 2 vaccinevaccine-induced thrombotic thrombocytopenia |
| spellingShingle | Vivek B Kute Sanshriti Chauhan Narayan Prasad Hari Shankar Meshram A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications Indian Journal of Transplantation deceased donation disseminated intravascular coagulation organ transplantation preimplantation biopsy severe acute respiratory syndrome coronavirus 2 vaccine vaccine-induced thrombotic thrombocytopenia |
| title | A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications |
| title_full | A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications |
| title_fullStr | A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications |
| title_full_unstemmed | A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications |
| title_short | A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications |
| title_sort | narrative review of vaccine induced thrombotic thrombocytopenia in organ donation and transplantation current evidence and implications |
| topic | deceased donation disseminated intravascular coagulation organ transplantation preimplantation biopsy severe acute respiratory syndrome coronavirus 2 vaccine vaccine-induced thrombotic thrombocytopenia |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=2;spage=169;epage=173;aulast=Kute |
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