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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
Summary
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.
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