Related Experiment Video
Updated: Sep 21, 2025
Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
Published on: November 7, 2020
Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference
Aline F Freitas1, Renata P S Pugliese1, Flavia Feier2
1Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo 01308-050, Brazil.
Insights
COVID-19 infection within six months after liver transplantation significantly increases disease severity in pediatric liver transplant recipients (PLTR). This finding highlights the critical importance of timing post-transplant for managing COVID-19 in this vulnerable population.
Area of Science:
- Immunology
- Hepatology
- Infectious Diseases
Background:
- COVID-19 (Coronavirus Disease 2019) presents significant respiratory risks, including severe acute respiratory syndrome (SARS-CoV-2).
- Limited data exists on SARS-CoV-2 outcomes in pediatric immunocompromised populations, particularly liver transplant recipients.
- This study addresses the knowledge gap by characterizing COVID-19 in pediatric liver transplant recipients (PLTR).
Purpose of the Study:
- To analyze the outcomes of the largest cohort of pediatric liver transplant recipients (PLTR) in Brazil infected with COVID-19.
- To identify predictors of COVID-19 severity in PLTR.
- To evaluate the impact of the timing of COVID-19 infection relative to liver transplantation (LT).
Main Methods:
- Cross-sectional study design.
- Primary outcome: COVID-19 severity assessment.
- Cox regression analysis to determine independent predictors of outcomes, comparing moderate-to-severe COVID-19 cases with asymptomatic-to-mild cases.
Main Results:
- Patients with moderate-to-severe COVID-19 were younger and more likely to have received transplants from deceased donors.
- A higher prevalence of COVID-19 infection within 6 months post-liver transplantation was observed in the moderate-to-severe group (75% vs. 5.7%).
- COVID-19 infection less than 6 months after LT was the sole independent predictor of disease severity (HR = 0.001, p = 0.03).
Conclusions:
- The interval of less than 6 months between COVID-19 infection and liver transplantation is a critical predictor of disease severity in pediatric patients.
- This finding underscores the heightened vulnerability of recently transplanted pediatric liver recipients to severe COVID-19.
- Timing of infection relative to LT is crucial for risk stratification and management strategies in PLTR.
Abstract:
Background: The COVID-19 infection has received the attention of the scientific community due to its respiratory manifestations and association with evolution to severe acute respiratory syndrome (SARS-CoV-2). There are few studies characterizing SARS-CoV-2 in pediatric immunocompromised patients, such as liver transplanted patients. The aim of this study was to analyze the outcomes of the largest cohort of pediatric liver transplant recipients (PLTR) from a single center in Brazil who were infected with COVID-19 during the pandemic. Methods: Cross-sectional study. Primary outcomes: COVID-19 severity. The Cox regression method was used to determine independent predictors associated with the outcomes. Patients were divided into two groups according to the severity of COVID-19 disease: moderate−severe COVID and asymptomatic−mild COVID. Results: Patients categorized as having moderate−severe COVID-19 were younger (12.6 months vs. 82.1 months, p = 0.03), had a higher prevalence of transplantation from a deceased donor (50% vs. 4.3%, p = 0.02), and had a higher prevalence of COVID infection within 6 months after liver transplantation (LT) (75% vs. 5.7%, p = 0.002). The independent predictor of COVID-19 severity identified in the multivariate analysis was COVID-19 infection <6 months after LT (HR = 0.001, 95% CI = 0.001−0.67, p = 0.03). Conclusion: The time interval of less than 6 months between COVID-19 infection and LT was the only predictor of disease severity in pediatric patients who underwent liver transplantation.
More Related Videos
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
08:04Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
Published on: July 9, 2014
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:26Kidney Transplant II: Surgical Procedure
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...