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Early Liver Transplant In Patients With Liver Cirrhosis Recovered From COVID-19 Infection
Ahad Eshraghian1, Hamed Nikoupour, Masood Dehghani
1From the Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Liver transplant is a viable option for patients with liver cirrhosis recovering from COVID-19. This study shows positive outcomes, supporting consideration for deceased donor liver transplants post-infection.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) poses significant risks to global health.
- Concerns exist regarding the management and safety of liver transplantation in patients post-COVID-19 recovery.
- Liver cirrhosis patients face unique challenges during and after COVID-19 infection.
Purpose of the Study:
- To investigate the clinical course and outcomes of liver transplant recipients with liver cirrhosis who recovered from COVID-19.
- To evaluate the safety and efficacy of deceased donor liver transplantation following COVID-19 recovery.
- To provide evidence-based recommendations for managing liver transplant candidates post-COVID-19.
Main Methods:
- A retrospective study included liver transplant recipients from April 1, 2020, to January 30, 2021.
- Focus on patients with decompensated liver cirrhosis who had recovered from COVID-19, confirmed by RT-PCR.
- Evaluation of clinical outcomes, including post-transplant SARS-CoV-2 status.
Main Results:
- 14 patients with liver cirrhosis recovered from COVID-19 underwent liver transplant.
- The average time from COVID-19 recovery to transplant was 56.14 days.
- Three patients (21.4%) experienced mortality; five patients (35.7%) tested positive for SARS-CoV-2 post-transplant.
Conclusions:
- Liver transplantation from deceased donors can be considered for patients with liver cirrhosis who have recovered from COVID-19.
- Transplantation is particularly recommended for patients experiencing clinical deterioration after COVID-19.
- This series supports the consideration of liver transplant in selected post-COVID-19 patients.
Objectives:
Coronavirus disease 2019 has resulted in significant morbidities and mortalities in nearly all parts ofthe world. There remain major concerns about management, timing, and safety of liver transplant in patients who have recovered from COVID-19. We aimed to study the clinical course and outcomes of patients with liver cirrhosis who recovered from COVID-19 and underwent liver transplant from deceased donors.
Materials And Methods:
A retrospective study was conducted on liver transplant recipients who underwent liver transplant from April 1, 2020, to January 30, 2021. We evaluated all recipients of liver transplantfrom deceased donors during this period in the COVID-19 pandemic.
Results:
There were 14 patients with decompensated liver cirrhosis who had recovered from COVID-19 as documented by reverse transcription-polymerase chain reaction test for SARS-CoV-2. Mean duration from COVID-19 to transplant surgery was 56.14 ± 29.96 days. Mortality occurred in 3 patients, and of whom 2 had been hospitalized and received medications for COVID-19 before transplant. Five patients had positive reverse transcription-polymerase chain reaction results for SARS-CoV-2 after liver transplant.
Conclusions:
This is a large reported series of patients with liver cirrhosis who have received liver transplant after recovery from COVID-19. We provided evidence that liver transplant from deceased donors should be considered in patients recovered from COVID-19, especially in those with deterioration of clinical status.
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