Update on Coronavirus 2019 Vaccine Guidelines for Transplant Recipients

The coronavirus disease 2019 (COVID-19) vaccine and its utility in solid organ transplantation need to be timely revised and updated. These guidelines have been formalized by the experts- the apex technical committee members of the National Organ and Tissue Transplant Organiza-tion and the heads of transplant societies-for the guidance of transplant communities. We rec-ommend that all personnel involved in organ transplantation should be vaccinated as early as possible and continue COVID-19-appropriate behavior despite a full course of vaccination. For specific guidelines of recipients, we suggest completing the full schedule before transplantation whenever the clinical condition permits. We also suggest a single dose, rather than proceeding unvaccinated for transplant, in case a complete course is not feasible. If vaccination is planned before surgery, we recommend a gap of at least 2 weeks between the last dose of vaccine and sur-gery. For those not vaccinated before transplant, we suggest waiting 4 to 12 weeks after trans-plant. For the potential living donors, we recommend the complete vaccination schedule before transplant. However, if this is not feasible, we suggest receiving at least a single dose of the vac-cine 2 weeks before donation. We suggest that suitable transplant patients and those on the wait-ing list should accept a third dose of the vaccine when one is offered to them. We recommend that organs from a deceased donor with suspected/proven vaccine-induced thrombotic thrombo-cytopenia should be avoided and are justified only in cases of emergency situations with informed consent and counseling.