Dealing With Liver Transplantation during Coronavirus Disease 2019 Pandemic: Normothermic Machine Perfusion Enables for Donor, Organ, and Recipient Assessment: A Case Report

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has changed life on a global scale. The numbers of transplantations have plummeted as a result of fear of disease transmission, recipient coronavirus disease 2019 infection, priority shift, and resource limitations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) complicates transplantation because donor testing, (re)allocation of limited resources, and recipient testing may exceed permissible ischemia times. Normothermic machine perfusion (NMP) helps safely prolong liver preservation up to 38 hours. Additional time is essential under the current circumstances. Here we present the case of a 29-year-old liver transplant recipient in whom prolonged liver preservation required for SARS-CoV-2 screening was accomplished through NMP. Donor and recipient test results for SARS-CoV-2 were negative, and intensive care unit capacity was eventually available. The surgical procedure and postoperative course were uneventful. NMP can extend preservation times in liver transplantation while awaiting SARS-CoV-2 test results and available intensive care unit capacity.

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

“…In this context, many local medical centers are now beginning to obtain consistent access to rapid reverse transcription-polymerase chain reaction (RT-PCR) diagnostics[ 3 , 15 ]. Moreover, machine perfusion has been used to extend preservation times of the liver graft while awaiting SARS-CoV-2 test results to be available[ 26 ]. As no molecular test is perfectly sensitive or specific, an additional epidemiological and clinical screening (which includes travel to a high-risk area, contact with a confirmed case, or onset of symptoms) of each case has been suggested[ 24 ].…”

Maschinenperfusion in der Lebertransplantation – was ist möglich und wo stehen wir in Deutschland? Übersicht der Literatur und Ergebnisse einer nationalen Umfrage

“…B. bei Split-Leber-oder Re-Transplantationen, denkbar. Eine ganz aktuelle Publikation zeigt dies am Beispiel der Coronaviruspandemie und der notwendigen Testung von Spendern und Empfängern aufunter Einsatz der NMP kann eine gleichbleibende kalte Ischämiezeit der Organe erreicht werden[38]. tiert[39].…”