Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region

Abstract

Highlights The COVID-19 pandemic is a public health emergency affecting all aspects of medical care, included liver transplant activity. We aimed to analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity. We compared the number of LT in the first two months with the same period of time in 2019, in our high-volume transplant Center (median 150 L T/year). Team working with close involvement of several specialties allowed our single regional Center to maintain its activity level, taking care of patients before and after LT. We think that LT, being a life-saving procedure, should be not suspended when it is possible. Sharing our experience, we hope to be helpful to other Transplant Centers that are now facing the COVID-19 emergency.

Impact of COVID‐19 lockdown measures on oncological surgical activity: Analysis of the surgical pathology caseload of a tertiary referral hospital in Northwestern Italy

“…Although Piedmont was initially the second most affected Italian region, our hospital reorganized health services according to the constant evolving needs through flexible interventions on individual medical and surgical units. The decision to promptly suspend all elective surgical procedures and deferrable outpatient clinics enabled to preserve as much as possible a timely oncological therapeutic workflow as well as to tackle other urgent needs like transplantation procedures (issue not reviewed in this paper) 11 . It should also be noted that this result was achieved despite the creation of nine dedicated COVID‐19 wards (including intensive care, internal medicine, and pneumology units) and the overall treatment of 375 patients with SARS‐CoV‐2 infection during the analyzed period.…”

Impact of the COVID-19 pandemic on liver donation and transplantation: A review of the literature

“…Other centers in areas where COVID-19 prevalence was low – or the infection reached its peak slowly – have continued their activity at a routine or even increased rate compared to 2019, being able in some cases to shunt COVID-19 affected patients elsewhere[ 17 - 20 ].…”

Involvement of the Liver in COVID-19: A Systematic Review

“…A summary of the liver management and recommendations are given in Table 4. [98][99][100][101][102][103][104][105][106][107][108][109][110] Diagnostic aspects. Liver function tests and abdominal imaging are the primary investigations done in relation to liver involvement in COVID-19 patients.…”

“…In Italy, though liver transplantation was carried out during COVID-19, a 25% reduction in procured organs was observed during the first 4 weeks of the outbreak. 107 Both living and deceased donor LTs were performed and increased mortality was seen in patients who needed to remain on the waiting list. 141 Saracco et al found no significant difference in numbers of patients undergoing LT from deceased donors in 2020 compared with 2019.…”