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COVID-19 and Effect on Liver Transplant

Yael R Nobel1, Meaghan Phipps1, Elizabeth C Verna1

  • 1Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, NY USA.

Current Treatment Options in Gastroenterology
|August 23, 2021
PubMed

Insights

Patients with chronic liver disease face higher COVID-19 risks. While liver transplant recipients may not have increased mortality, careful management and evolving guidelines are crucial for managing Coronavirus disease-2019 (COVID-19) in this population.

Area of Science:

  • Hepatology
  • Transplantation immunology
  • Infectious diseases

Background:

  • The Coronavirus disease-2019 (COVID-19) pandemic has presented unprecedented challenges in liver transplantation.
  • Patients with chronic liver disease, particularly cirrhosis, exhibit heightened vulnerability to severe COVID-19 outcomes.

Purpose of the Study:

  • To review current literature on COVID-19 clinical outcomes, treatment strategies, and vaccination considerations for liver transplant candidates and recipients.
  • To synthesize evolving guidelines and recommendations for managing liver transplant care during the COVID-19 pandemic.

Main Methods:

  • Comprehensive literature review of studies focusing on COVID-19 in liver transplant populations.
  • Analysis of clinical outcomes, treatment efficacies, and safety profiles of COVID-19 therapies in patients with liver disease and transplant recipients.

Main Results:

  • While chronic liver disease patients face increased COVID-19 morbidity and mortality, this trend is not consistently observed in liver transplant recipients.
  • Severe COVID-19 in transplant recipients is primarily linked to advanced age and comorbidities, not solely transplant-related factors.
  • Certain COVID-19 therapies with known hepatotoxicity may be safely administered to liver transplant patients.

Conclusions:

  • COVID-19 has profoundly impacted liver transplantation, necessitating adaptive clinical practices.
  • Ongoing research is needed to address transmission risks via donor livers and the safety of transplantation during active COVID-19.
  • Evolving guidelines are essential for the safe and effective management of liver transplant candidates and recipients in the context of COVID-19.
Abstract

Keywords:
COVID-19Chronic liver diseaseLiver transplantationSARS-CoV-2Solid organ transplant

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