FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3177337788> ?p ?o ?g. }

• W3177337788 endingPage "4097" @default.
• W3177337788 startingPage "4095" @default.
• W3177337788 abstract "To the Editor: Vaccine-induced thrombosis and thrombocytopenia (VITT) may follow immunization with the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2.1, 2 Autoantibodies to platelet factor 4 (PF4) may mediate VITT through antibody-dependent platelet activation, though the underlying etiology is uncertain.3 Anti-PF4 antibodies are also seen in heparin-induced thrombocytopenia, though most cases of VITT do not have prior heparin exposure. More than 20 million people in the United Kingdom (UK) have received the ChAdOx1 nCoV-19 vaccine. We carried out an early analysis of organ donation and transplantation from UK donors with VITT, to understand the implications of this emerging syndrome. Articles 6(1)(e) and 9(2)(h) and (i) of the General Data Protection Regulations provide the basis for NHSBT to use patient identifiable data without prior consent, for the purposes of monitoring the safety of the national transplant program. We identified 13 consented deceased organ donors, who presented with thrombosis and/or hemorrhage and laboratory features consistent with VITT,4 between 28 January and 9 April 2021. All had received their first dose of ChAdOx1 nCoV-19 vaccine before admission (see Table 1). Ten donors proceeded to donate 27 allografts to 26 recipients. After a median follow-up of 19 days, 21 of 27 (78%) allografts have satisfactory function. Three recipients developed early allograft failure requiring explantation (two livers and one kidney); two transplanted kidneys have impaired allograft function, currently requiring hemodialysis; and one recipient died within a day of transplantation from a presumed cardiac event. There were seven major thrombotic or hemorrhagic postoperative complications (three bleeds and four venous or arterial allograft thromboses) in six recipients, resulting in the loss of three transplants as described above; these events occurred within 9 days of transplantation. Of the six recipients with bleeding or thrombotic events, two had received their second dose of ChAdOx1 nCoV-19 vaccine within 30 days before transplantation; neither patient had features suggestive of VITT at the time of transplantation. Two of the three patients with bleeding had preexisting risk factors for hemorrhage (dual antiplatelet agent therapy, anticoagulation for metallic cardiac valve); none of the patients with thromboses had significant preexisting procoagulant tendencies. So far, three liver recipients had detectable anti-PF4 antibodies between 3 and 22 days posttransplant; one of these recipients experienced a thrombotic complication without allograft loss and the other two had uncomplicated postoperative courses. Ten recipients (six kidneys and four livers) tested negative for anti-PF4 antibodies. The UK experience to date suggests that the potential risks of transplanting organs from donors with VITT are twofold. First, early major thrombosis or clinically significant bleeding, which may result from preexisting hemostatic and endothelial dysfunction in the allograft. Second, possible transmission of pathogenic lymphocytes producing anti-PF4. The clinical significance of this is unclear; further follow-up will determine whether this portends development of VITT in the recipient. UK guidance has been drawn up for the selection, recovery, and transplantation of organs from donors with VITT, as well as recipient monitoring.5 We suggest that liver, lung, pancreas, and small bowel transplants from donors with VITT should only proceed in urgent situations, as these organs contain high numbers of “passenger” donor lymphocytes. Since anti-PF4 antibodies can provoke platelet activation and thromboses, platelet transfusion should be avoided during organ recovery and transplantation processes where possible. The contribution of systemic heparinization during organ recovery to thrombosis within the allograft is uncertain, and argatroban is an alternative anticoagulant.5 Current UK guidance recommends that heparin can be used as per standard practice in the recipient unless features of VITT develop.5 For recipients of organs from VITT donors, monitoring of the platelet count, fibrinogen, D-dimers, and anti-PF4 antibodies is essential.5 Further experience of organ transplantation from donors with VITT and longer term recipient follow-up will help guide clinical decision-making. In the meantime, transplantation of organs from these donors should only proceed after careful consideration of the methods for organ recovery and of the risks and benefits for a potential recipient, and an appropriate consent discussion. The authors are grateful to the organ donation teams, specialist nurses in organ donation, National Organ Retrieval Service teams, and the staff of the platelet immunology laboratory at NHSBT Filton who assisted with aspects of donor characterization. They also thank the recipient transplant coordinators, and other members of the transplant teams caring for the transplant recipients, who supplied follow-up information required for this study. Lastly, and most of all, they thank all deceased donors and their families. The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation." @default.
• W3177337788 created "2021-07-05" @default.
• W3177337788 creator A5001008330 @default.
• W3177337788 creator A5001602849 @default.
• W3177337788 creator A5002450989 @default.
• W3177337788 creator A5003656768 @default.
• W3177337788 creator A5004439314 @default.
• W3177337788 creator A5004457925 @default.
• W3177337788 creator A5004886985 @default.
• W3177337788 creator A5005274397 @default.
• W3177337788 creator A5007627841 @default.
• W3177337788 creator A5009130930 @default.
• W3177337788 creator A5009725501 @default.
• W3177337788 creator A5010547673 @default.
• W3177337788 creator A5010972793 @default.
• W3177337788 creator A5022664528 @default.
• W3177337788 creator A5025156898 @default.
• W3177337788 creator A5025576223 @default.
• W3177337788 creator A5032411762 @default.
• W3177337788 creator A5036117738 @default.
• W3177337788 creator A5037675863 @default.
• W3177337788 creator A5044872358 @default.
• W3177337788 creator A5047273603 @default.
• W3177337788 creator A5047829867 @default.
• W3177337788 creator A5052460380 @default.
• W3177337788 creator A5053326233 @default.
• W3177337788 creator A5058370603 @default.
• W3177337788 creator A5061114011 @default.
• W3177337788 creator A5067655371 @default.
• W3177337788 creator A5069234874 @default.
• W3177337788 creator A5069748136 @default.
• W3177337788 creator A5070838733 @default.
• W3177337788 creator A5072114459 @default.
• W3177337788 creator A5076860558 @default.
• W3177337788 creator A5078181052 @default.
• W3177337788 creator A5078778737 @default.
• W3177337788 creator A5079255883 @default.
• W3177337788 creator A5082200338 @default.
• W3177337788 creator A5090484568 @default.
• W3177337788 creator A5091807146 @default.
• W3177337788 date "2021-12-01" @default.
• W3177337788 modified "2023-10-17" @default.
• W3177337788 title "Organ transplantation from deceased donors with vaccine-induced thrombosis and thrombocytopenia" @default.
• W3177337788 cites W3140226555 @default.
• W3177337788 cites W3152102956 @default.
• W3177337788 cites W3154877986 @default.
• W3177337788 doi "https://doi.org/10.1111/ajt.16735" @default.
• W3177337788 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8441635" @default.
• W3177337788 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/34214257" @default.
• W3177337788 hasPublicationYear "2021" @default.
• W3177337788 type Work @default.
• W3177337788 sameAs 3177337788 @default.
• W3177337788 citedByCount "14" @default.
• W3177337788 countsByYear W31773377882021 @default.
• W3177337788 countsByYear W31773377882022 @default.
• W3177337788 countsByYear W31773377882023 @default.
• W3177337788 crossrefType "journal-article" @default.
• W3177337788 hasAuthorship W3177337788A5001008330 @default.
• W3177337788 hasAuthorship W3177337788A5001602849 @default.
• W3177337788 hasAuthorship W3177337788A5002450989 @default.
• W3177337788 hasAuthorship W3177337788A5003656768 @default.
• W3177337788 hasAuthorship W3177337788A5004439314 @default.
• W3177337788 hasAuthorship W3177337788A5004457925 @default.
• W3177337788 hasAuthorship W3177337788A5004886985 @default.
• W3177337788 hasAuthorship W3177337788A5005274397 @default.
• W3177337788 hasAuthorship W3177337788A5007627841 @default.
• W3177337788 hasAuthorship W3177337788A5009130930 @default.
• W3177337788 hasAuthorship W3177337788A5009725501 @default.
• W3177337788 hasAuthorship W3177337788A5010547673 @default.
• W3177337788 hasAuthorship W3177337788A5010972793 @default.
• W3177337788 hasAuthorship W3177337788A5022664528 @default.
• W3177337788 hasAuthorship W3177337788A5025156898 @default.
• W3177337788 hasAuthorship W3177337788A5025576223 @default.
• W3177337788 hasAuthorship W3177337788A5032411762 @default.
• W3177337788 hasAuthorship W3177337788A5036117738 @default.
• W3177337788 hasAuthorship W3177337788A5037675863 @default.
• W3177337788 hasAuthorship W3177337788A5044872358 @default.
• W3177337788 hasAuthorship W3177337788A5047273603 @default.
• W3177337788 hasAuthorship W3177337788A5047829867 @default.
• W3177337788 hasAuthorship W3177337788A5052460380 @default.
• W3177337788 hasAuthorship W3177337788A5053326233 @default.
• W3177337788 hasAuthorship W3177337788A5058370603 @default.
• W3177337788 hasAuthorship W3177337788A5061114011 @default.
• W3177337788 hasAuthorship W3177337788A5067655371 @default.
• W3177337788 hasAuthorship W3177337788A5069234874 @default.
• W3177337788 hasAuthorship W3177337788A5069748136 @default.
• W3177337788 hasAuthorship W3177337788A5070838733 @default.
• W3177337788 hasAuthorship W3177337788A5072114459 @default.
• W3177337788 hasAuthorship W3177337788A5076860558 @default.
• W3177337788 hasAuthorship W3177337788A5078181052 @default.
• W3177337788 hasAuthorship W3177337788A5078778737 @default.
• W3177337788 hasAuthorship W3177337788A5079255883 @default.
• W3177337788 hasAuthorship W3177337788A5082200338 @default.
• W3177337788 hasAuthorship W3177337788A5090484568 @default.
• W3177337788 hasAuthorship W3177337788A5091807146 @default.
• W3177337788 hasBestOaLocation W31773377881 @default.
• W3177337788 hasConcept C126322002 @default.
• W3177337788 hasConcept C141071460 @default.

• next