Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 26 , ISSUE 4 ( April, 2022 ) > List of Articles


Case of Suspected SARS-CoV-2 Vaccine-induced Immune Thrombotic Thrombocytopenia: Dilemma for Organ Donation

Sushma K Gurav, Lomesh B Bhirud, Rupali S Suryawanshi, Shilpa S Kulkarni

Keywords : Cerebral venous sinus thrombosis, COVID vaccine, Organ donation, PF4 antibody, Thrombocytopenia, Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), Vaccine-induced thrombotic thrombocytopenia (VITT)

Citation Information : Gurav SK, Bhirud LB, Suryawanshi RS, Kulkarni SS. Case of Suspected SARS-CoV-2 Vaccine-induced Immune Thrombotic Thrombocytopenia: Dilemma for Organ Donation. Indian J Crit Care Med 2022; 26 (4):516-519.

DOI: 10.5005/jp-journals-10071-24184

License: CC BY-NC 4.0

Published Online: 13-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Several vaccines were developed and rolled out at an unprecedented rate in response to the coronavirus disease-2019 (COVID-19) pandemic. Most vaccines approved globally by WHO for emergency use to combat the pandemic were deemed remarkably effective and safe. Despite the safety, rare incidences of vaccine-induced thrombosis and thrombocytopenia (VITT), sometimes known as vaccine-induced prothrombotic thrombocytopenia (VIPIT), have been reported. We report a case of young female with prothrombotic conditions and suspected VITT who developed catastrophic cerebral venous sinus thrombosis (CVST) and progressed to brain death. We highlight hurdles of organ retrieval from a brain-dead patient with suspected SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. There is limited data and lack of substantial evidence regarding transplantation of organs from brain-dead patients with suspected VITT.

  1. Bereau M. Vaccination and induction of autoimmune diseases. Inflamm Allergy Drug Targets 2015;14(2):94–98. DOI: 10.2174/1871528114666160105113046.
  2. Chen PW, Tsai ZY, Chao TH, Li YH, Hou CJ, Liu PY. Addressing vaccine-induced immune thrombotic thrombocytopenia (VITT) following COVID-19 vaccination: a mini-review of practical strategies. Acta Cardiol Sin 2021;37(4):355. DOI: 10.6515/ACS.202107_37(4).20210628A.
  3. Franchini M, Liumbruno GM, Pezzo M. COVID-19 vaccine-associated immune thrombosis and thrombocytopenia (VITT): diagnostic and therapeutic recommendations for a new syndrome. Eur J Haematol 2021;107(2):173–180. DOI: 10.1111/ejh.13665.
  4. Dotan A, Shoenfeld Y. Perspectives on vaccine induced thrombotic thrombocytopenia. J Autoimmun 2021;121:102663. DOI: 10.1016/j.jaut.2021.102663.
  5. Pandit RA, Zirpe KG, Gurav SK, Kulkarni AP, Karnath S, Govil D, et al. Management of potential organ donor: Indian Society of Critical Care Medicine: position statement. Indian J Crit Care Med 2017;21(5):303–316. DOI: 10.4103/ijccm.IJCCM_160_17.
  6. Kulkarni AP. Let there be guidance!!! Indian J Crit Care Med 2020;24(Suppl 1):S1. DOI: 10.5005/jp-journals-10071-G23181.
  7. Silvis SM, De Sousa DA, Ferro JM, Coutinho JM. Cerebral venous thrombosis. Nat Rev Neurol 2017;13(9):555–565. DOI: 10.1038/nrneurol.2017.104.
  8. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004;35(3):664–670. DOI: 10.1161/01.STR.0000117571.76197.26.
  9. Ferro JM, Sousa DA, Coutinho JM, Martinelli I. European stroke organization interim expert opinion on cerebral venous thrombosis occurring after SARS-CoV-2 vaccination. Eur Stroke J 2021:23969873211030842. DOI: 10.1177/23969873211030842.
  10. Pai M, Chan B, Stall NM, Grill A, Ivers N, Maltsev A, et al. Vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenovirus vector COVID-19 vaccination. Science Briefs of the Ontario COVID-19 Science Advisory Table. Infect Dis Clin Care 2021;2(17):1–7. DOI: 10.47326/ocsat.2021.
  11. Duman T, Uluduz D, Midi I, Bektas H, Kablan Y, Goksel BK, et al. A multicenter study of 1144 patients with cerebral venous thrombosis: the VENOST study. J Stroke Cerebrovasc Dis 2017;26(8):1848–1857. DOI: 10.1016/j.jstrokecerebrovasdis.2017.04.020.
  12. UK Donor VITT Transplant Study Group, Greenhall GHB, Ushiro-Lumb I, Pavord S, Currie I, Perera MTPR, et al. Organ transplantation from deceased donors with vaccine-induced thrombosis and thrombocytopenia. Am J Transplant 2021:10.1111/ajt.16735. DOI: 10.1111/ajt.16735.
  13. Greenhall GH, Ushiro-Lumb I, Pavord S, Currie I, Perera MT, Hartog H, et al. Organ transplantation from deceased donors with vaccine-induced thrombosis and thrombocytopenia. Am J Transplant 2021. DOI: 10.1111/ajt.16735.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.