key: cord-0817999-snicridy
authors: Mungmunpuntipantip, Rujittika; Wiwanitkit, Viroj
title: Correspondence on “Acute corneal endothelial graft rejection following COVID-19 vaccination”
date: 2021-11-01
journal: J Fr Ophtalmol
DOI: 10.1016/j.jfo.2021.10.003
sha: 22b9f0a5a3618c981c854226d8910ea36734d713
doc_id: 817999
cord_uid: snicridy

nan

Dear Editor, we would like to share ideas on "Acute corneal endothelial graft rejection following COVID-19 vaccination.. [1] ." Crnej et al. concluded that SARS-CoV-2 vaccination might disrupt immune regulation enough to cause cornea transplant rejection [1] . We agree that there is an abnormal immunological process in the present. However, whether it is only a co-incidence or not requires further investigation. After a vaccination, a hyperstimulation of immune system might occur and it might result in a graft loss. The graft loss after vaccination is also reported in other vaccination such as yellow fever vaccination [2] . For COVID-19 vaccination, a response to vaccine can result in a rapid increasing of plasma viscosity [3] . Regarding this hypothesis, when COVID-19 vaccine is given, the immune response will occur and there is a rapid change of viscosity in circulation due to increased immune elements [3] . In some vaccine recipients, the hyperviscosity might occur and can lead to clinical problems [3] . Regarding graft rejection, high plasma viscosity is associated with cellular graft loss [4] . In animal transplantation model study, a high viscosity condition can block or a proper perfusion to graft area and decreased graft survival chance is a result [5] 

The authors declare that they are no conflict of interest

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