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Updated: Nov 16, 2025
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Liver transplantation performed in a SARS-CoV-2 positive hospitalized recipient using a SARS-CoV-2 infected donor
Tommaso Maria Manzia1, Carlo Gazia1, Ilaria Lenci2
1Hepato-Pancreato-Biliary and Transplant Unit, University of Rome Tor Vergata, Rome, Italy.
Insights
This study details the first successful liver transplant using a liver from a donor positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The recipient, also SARS-CoV-2 positive, recovered, demonstrating a life-saving option for eligible patients.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- COVID-19, caused by SARS-CoV-2, is a global pandemic.
- Liver transplantation (LT) is a critical treatment for end-stage liver disease.
- Donor scarcity remains a significant challenge in LT.
Observation:
- A 35-year-old female patient with HBV-HDV-related end-stage liver disease (MELD=32) was SARS-CoV-2 positive.
- The patient possessed neutralizing SARS-CoV-2 antibodies (titer 1:320).
- A liver procured from a SARS-CoV-2 positive donor was used for transplantation.
Findings:
- The liver transplant was technically successful.
- The graft is functioning well two months post-surgery.
- The recipient cleared the SARS-CoV-2 infection one month after LT.
Implications:
- Utilizing SARS-CoV-2 positive donors can expand the donor pool for LT.
- This approach offers a life-saving option for SARS-CoV-2 positive patients with neutralizing antibodies.
- Careful patient selection and management are crucial for successful transplantation from infected donors.
Abstract:
The coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 currently affected more than 108 million people worldwide with a fatality rate of 2.2%. Herein, we report the first case of liver transplantation (LT) performed with a liver procured from a SARS-CoV-2 positive donor. The recipient was a 35-year-old SARS-CoV-2 positive female patient affected by severe end-stage HBV-HDV-related liver disease (model of end-stage liver disease = 32) who had neutralizing SARS-CoV-2 antibodies (titers 1:320) at time of LT. The LT was successful, and the graft is functioning two months after surgery. The recipient cleared the SARS-CoV-2 infection 1 month after LT. The current case shows that the prompt use of SARS-CoV-2 infected liver donors offers an invaluable life-saving opportunity for SARS-CoV-2 positive wait-listed patients who developed neutralizing SARS-CoV-2 antibodies.
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