{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:36:56Z","timestamp":1788968216956,"version":"build-2803163510"},"reference-count":111,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>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\u201317.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5\u201321). 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.<\/jats:p>","DOI":"10.3390\/vaccines10081289","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:47:06Z","timestamp":1660124826000},"page":"1289","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-4513","authenticated-orcid":false,"given":"Saad","family":"Alhumaid","sequence":"first","affiliation":[{"name":"Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-9847","authenticated-orcid":false,"given":"Ali A.","family":"Rabaan","sequence":"additional","affiliation":[{"name":"Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia"},{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Public Health\/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7469-4752","authenticated-orcid":false,"given":"Kuldeep","family":"Dhama","sequence":"additional","affiliation":[{"name":"Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatangar, Bareilly 243122, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin Jie","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Subang Jaya 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0989-4023","authenticated-orcid":false,"given":"Firzan","family":"Nainu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1725-6702","authenticated-orcid":false,"given":"Khalid","family":"Hajissa","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah Al","family":"Dossary","sequence":"additional","affiliation":[{"name":"General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khulood Khaled","family":"Alajmi","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Al-Ahsa Mental Health Hospital, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afaf E. Al","family":"Saggar","sequence":"additional","affiliation":[{"name":"Administration of Accreditation, Quality and Performance Excellence Management, Riyadh 3rd Health Cluster, Ministry of Health, Riyadh 13717, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad Abdullah","family":"AlHarbi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Services\u2014Nephrology Department, King Saud Hospital, Ministry of Health, Riyadh 56437, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Buhays","family":"Aswany","sequence":"additional","affiliation":[{"name":"Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Abdulaziz","family":"Alshayee","sequence":"additional","affiliation":[{"name":"Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Abdalaziz","family":"Alrabiah","sequence":"additional","affiliation":[{"name":"Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mahmoud","family":"Saleh","sequence":"additional","affiliation":[{"name":"Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Ali","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Administration of Supply and Shared Services, C1 Riyadh Health Cluster, Ministry of Health, Riyadh 11622, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad Mohammed Al","family":"Gharib","sequence":"additional","affiliation":[{"name":"Administration of Compliance, Directorate of Health Affairs, Ministry of Health, Eastern Region, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahd Nabeel","family":"Qattan","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology Department, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan M.","family":"Almusabeh","sequence":"additional","affiliation":[{"name":"Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussain Yousef","family":"AlGhatm","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Gurayat General Hospital, Ministry of Health, Gurayat 77471, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer Ahmed","family":"Almoraihel","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Saeed","family":"Alzuwaid","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Ali","family":"Albaqshi","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtadha Ahmed Al","family":"Khalaf","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 77110, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine Ahmed","family":"Albaqshi","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulsatar H Al","family":"Brahim","sequence":"additional","affiliation":[{"name":"Pharmacy Department, King Fahad Hofuf Hospital, Ministry of Health, Al-Ahsa 36441, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi Mana","family":"Al Mutared","sequence":"additional","affiliation":[{"name":"Psychological Service Department, Ardha and Mental Health Complex, Ministry of Health, Najran 66248, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Al-Helal","sequence":"additional","affiliation":[{"name":"Division of Laboratory, Medical Microbiology Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Header A","family":"Alghazal","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Al Mutair","sequence":"additional","affiliation":[{"name":"Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia"},{"name":"College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia"},{"name":"School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia"},{"name":"Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1056\/NEJMra2035343","article-title":"Maintaining safety with SARS-CoV-2 vaccines","volume":"384","author":"Castells","year":"2021","journal-title":"N. 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