Clinical Practice Issues for Liver Transplantation in COVID-19 Recovered Recipients

Area of Science:

• Hepatology and Transplant Surgery
• Infectious Diseases and Virology

Background:

• The COVID-19 pandemic presents unique challenges for organ transplantation in patients with end-stage liver failure.
• Previous transplant experiences with COVID-19 recovered recipients highlighted potential risks and necessitated policy re-evaluation.

Purpose of the Study:

• To analyze the clinical course and outcomes of liver transplant recipients with a history of COVID-19.
• To identify predictors of adverse outcomes in this patient population.
• To inform and refine organ transplantation policies during the COVID-19 era.

Main Methods:

• Retrospective analysis of seven COVID-19 recovered liver transplant recipients.
• Evaluation of clinical data, including SARS-CoV-2 PCR status, liver failure severity, and thromboembolic events.
• Comparison of outcomes between deceased and successfully transplanted patients.

Main Results:

• Two of the seven recipients experienced early mortality post-transplant.
• Deceased patients had positive SARS-CoV-2 PCR tests within 7-17 days of transplant, acute-on-chronic liver failure, and thromboembolic complications.
• Five recipients had successful transplant outcomes.

Conclusions:

• Recent SARS-CoV-2 infection and specific clinical factors are associated with poor outcomes after liver transplantation.
• Transplantation should be carefully considered in patients with recent positive PCR tests, severe liver failure, and a history of thromboembolism.
• These findings offer critical insights for developing rational organ transplantation policies in the context of COVID-19.