Kidney Transplantation from Deceased Donors with Vaccine-Induced Thrombosis and Thrombocytopenia: An Updated Analysis of the UK Experience

ABSTRACT

Purpose: Vaccine-induced thrombosis and thrombocytopenia (VITT) is a rare syndrome that has emerged since widespread vaccination against SARS-CoV-2. As a result of the high mortality, some patients have become deceased organ donors. Outcomes after kidney transplantation from donors with VITT are poorly described. Since the disease appears to be antibody-mediated, there is a theoretical risk of transmission from donor to recipient. Method(s) We examined the UK experience of kidney transplantation from donors with VITT, using data from the UK Transplant Registry. Our outcomes were early graft function, post-operative complications, 3-month estimated glomerular filtration rate (eGFR), patient and graft survival, and disease transmission. Result(s) Thirty patients (including two aged <18 years) received a single kidney transplant from 16 donors with VITT between 1st January and 30th June 2021. After a median follow-up of 5 months, patient and graft survival were 97% and 90%, respectively. Median 3-month eGFR was 51 mL/min/1.73m2. Two recipients had detectable anti-platelet factor 4 antibodies following transplantation, but no evidence of clinical disease. Major haemorrhagic or thrombotic complications occurred in three recipients, resulting in the loss of two grafts. Conclusion(s) The UK experience to date shows that favourable outcomes in kidney transplants from donors with VITT are possible. Ongoing vigilance for donor-related complications in these patients remains important. (Table Presented).