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Coronavirus Precautions: Experience of High Volume Liver Transplant Institute
Adil Başkıran1, Sami Akbulut1, Tevfik Tolga Şahin1
1Department of Surgery and Liver Transplant Institute, İnönü University Faculty of Medicine, Malatya, Turkey.
Insights
High-volume liver transplant centers faced challenges during the coronavirus infectious disease-2019 pandemic. Despite infections among staff and candidates, meticulous precautions enabled continued, safe liver transplantation.
Area of Science:
- Transplant Surgery
- Infectious Diseases
- Public Health
Background:
- The coronavirus infectious disease-2019 (COVID-19) pandemic presented unprecedented challenges to healthcare systems globally.
- High-volume liver transplant centers, in particular, had to adapt rapidly to maintain patient care amidst the crisis.
Purpose of the Study:
- To describe the impact of the COVID-19 pandemic on a high-volume liver transplant center.
- To analyze the outcomes of liver transplant staff and candidates infected with COVID-19.
- To evaluate the safety and feasibility of liver transplantation during the pandemic.
Main Methods:
- A prospective analysis of demographic and clinical data of liver transplant staff and candidates diagnosed with COVID-19 between March 2020 and December 2020.
- Review of infection control measures, treatment protocols, and transplant outcomes.
Main Results:
- 32 healthcare staff and 13 liver transplant candidates tested positive for COVID-19; all staff recovered.
- One recipient with severe COVID-19 died from multiple organ failure; another recipient died postoperatively.
- Liver transplant procedures were performed after a median of 21 days post-diagnosis, with negative pre-operative PCR tests and no signs of viral pneumonia on imaging.
Conclusions:
- Successful liver transplantation during the COVID-19 pandemic is achievable with stringent precautions, a multidisciplinary approach, and robust organizational strategies.
- Healthcare workers' dedication and adaptability were crucial in navigating the pandemic's challenges in liver transplantation.
Background:
To present the struggle of a high volume liver transplant center against coronavirus infectious disease-2019 pandemic.
Methods:
Between March 2020 and December 2020, the demographic and clinical data of staff and liver transplant candidates diagnosed with coronavirus infectious disease-2019 in our Liver Transplant Institute were prospectively analyzed.
Results:
First, 32 healthcare staff were diagnosed with coronavirus infectious disease-2019, and 6 of them were surgeons. Six staff were asymptomatic, while 24 staff had mild or moderate and 2 staff had severe coronavirus infectious disease-2019. All the staff recovered from the disease without any permanent sequela and returned to duty after 2 consecutive negative polymerase chain reaction results within 24-hour intervals. Second, during the preoperative investigation, 6 living liver donor candidates and 13 recipients were tested positive for coronavirus infectious disease-2019 (son = 6, unrelated = 3, cousin = 3, daughter = 2, cadaveric = 1). Eleven patients received favipiravir and 8 did not receive any treatment because they were asymptomatic. Only one recipient who had severe coronavirus infectious disease-2019 died due to multiple organ failure syndrome. One recipient died in the early postoperative period. The median duration from the initial diagnosis of the patients till the transplant procedure was 21 days (min-max: 14-105 days). During the time of operation, the polymerase chain reaction tests of the donors and the recipients were negative, and the thorax tomography images showed no signs of viral pneumonia.
Conclusion:
Meticulous precautions, multidisciplinary approach, team effort, and organization of facilities can increase the quality of care of these patients in the coronavirus infectious disease-2019 era. Healthcare workers have shown tremendous effort and are the true heroes of this era.
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