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Liver transplantation can be performed safely without using corticosteroids in the early postoperative course, and there is no need for routine aggressive steroid treatment of established acute rejections.

The coronavirus disease 2019 (COVID‐19) is a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). COVID‐19 currently affected more than 108 million people worldwide with a fatality rate of 2.2%. Herein, we report the first case of liver transplantation (LT) performed with a liver procured from a SARS‐CoV‐2 positive donor. The recipient was a 35‐year‐old SARS‐CoV‐2 positive female patient affected by severe end‐stage HBV‐HDV‐related liver disease (model of end‐stage liver disease = 32) who had neutralizing SARS‐CoV‐2 antibodies (titers 1:320) at time of LT. The LT was successful, and the graft is functioning two months after surgery. The recipient cleared the SARS‐CoV‐2 infection 1 month after LT. The current case shows that the prompt use of SARS‐CoV‐2 infected liver donors offers an invaluable life‐saving opportunity for SARS‐CoV‐2 positive wait‐listed patients who developed neutralizing SARS‐CoV‐2 antibodies.

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The use of TUDCA during harvesting and cold storage of human liver is associated with significant protection from ischemia-reperfusion injury. The clinical significance of this findings must be studied.

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BackgroundRenal denervation represents an emerging treatment for resistant hypertension in patients with end‐stage renal disease, but data about the anatomic substrate of this treatment are lacking. Therefore, the aim of this study was to investigate the morphological basis of sympathetic hyperactivity in the setting of hemodialysis patients to identify an anatomical substrate that could warrant the use of this new therapeutic approach.Methods and ResultsThe distribution of sympathetic nerves was evaluated in the adventitia of 38 renal arteries that were collected at autopsy or during surgery from 25 patients: 9 with end‐stage renal disease on dialysis (DIAL group) and 16 age‐matched control nondialysis patients (CTRL group). Patients in the DIAL group showed a significant increase in nerve density in the internal area of the peri‐adventitial tissue (within the first 0.5 mm of the beginning of the adventitia) compared with the CTRL group (4.01±0.30 versus 2.87±0.28×mm2, P=0.01). Regardless of dialysis, hypertensive patients with signs of severe arteriolar damage had a greater number of nerve endings in the most internal adventitia, and this number was significantly higher than in patients without hypertensive arteriolar damage (3.90±0.36 versus 2.87±0.41×mm2, P=0.04), showing a correlation with hypertensive arteriolar damage rather than with hypertensive clinical history.ConclusionsThe findings from this study provide a morphological basis underlying sympathetic hyperactivity in patients with end‐stage renal disease and might offer useful information to improve the use of renal denervation in this group of patients.