Impact of COVID‐19 on liver transplantation in Europe: alert from an early survey of European Liver and Intestine Transplantation Association and European Liver Transplant Registry

Polak, Wojciech; Fondevila, Constantino; Karam, Vincent; Adam, René; Baumann, Ulrich; Germani, Giacomo; Nadalin, Silvio; Taimr, Pavel; Toso, Christian; Troisi, Roberto; Zieniewicz, Krzysztof; Belli, Luca; Duvoux, Christophe

doi:10.1111/tri.13680

Cited by 51 publications

(74 citation statements)

References 15 publications

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“…No evidence-based treatment has been approved so far. 2 4 We present our experience of 12 adult (11 males) living donor liver transplant (LDLT) recipients who tested positive for SARS-CoV-2 RT PCR in respiratory swabs. The mean age of patients was 53.6  9.2 years.…”

mentioning

confidence: 99%

Outcomes of Coronavirus Disease 2019 in Living Donor Liver Transplant Recipients

et al. 2020

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mentioning

confidence: 99%

Outcomes of Coronavirus Disease 2019 in Living Donor Liver Transplant Recipients

et al. 2020

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“…Based on a recent survey from European LT registry, the crude incidence of COVID-19 in patients awaiting liver transplantation was 1.05% (0.5-20%) with a crude death rate of 18%. Similarly, in post- LT patients the incidence was 0.34% (0.1-4.8%), with a crude death rate 15% 77 .…”

Section: Liver and Sars- Cov-2mentioning

confidence: 89%

Post liver transplant recurrent and de novo viral infections

Jothimani

Venugopal

Vij

et al. 2020

Best Practice & Research Clinical Gastroenterology

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Survival following liver transplantation has changed dramatically owing to improvement in surgical techniques, peri-operative care and optimal immunosuppressive therapy. Post-Liver transplant (LT) de novo or recurrent viral infection continues to cause major allograft dysfunction, leading to poor graft and patient survival in untreated patients. Availability of highly effective antiviral drugs has significantly improved post-LT survival. Patients transplanted for chronic hepatitis B infection should receive life-long nucleos(t)ide analogues, with or without HBIg for effective viral control. Patients with chronic hepatitis C should be commenced on directly acting antiviral (DAA) drugs prior to transplantation. DAA therapy for post-LT recurrent hepatitis C infection is associated with close to 100% sustained virological response (SVR), irrespective of genotype. De novo chronic Hepatitis E infection is an increasingly recognised cause of allograft dysfunction in LT recipients. Untreated chronic HEV infection of the graft may lead to liver fibrosis and allograft failure. Similarly, CMV and EBV can reactivate leading to systemic illness following liver transplantation. With COVID-19 pandemic, post-transplant patients are at risk of SARS-Co-V2 infection. Majority of the LT recipients require hospitalisation, and the mortality in this population is around 20%. Early recognition of allograft dysfunction and identification of viral aetiology is essential in the management of post-LT de novo or recurrent infections. Optimising immunosuppression is an important step in reducing the severity of allograft damage in the treatment of post-transplant viral infections. Viral clearance or control can be achieved by early initiation of high potency antiviral therapy.

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“…This mandates caution and candidates for transplantation are delayed if their condition allows to. However, countries where social distancing measures have been in place for as long as the median virus incubation time, have the opportunity to rule out possible false negative tests from recipients who have complied with the social restriction policy [6,7].…”

Section: Timing and Logistics Of Transplantationmentioning

confidence: 99%

Transplantation during the COVID-19 pandemic: nothing noble is accomplished without danger

et al. 2020

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The global health crisis due to the fast spread of coronavirus disease (COVID-19) has caused major disruption in all aspects of healthcare. Transplantation is one of the most affected sectors, as it relies on a variety of services that have been drastically occupied to treat patients affected by COVID-19. With this report from two transplant centers in Italy, we aim to reflect on resource organization, organ allocation, virus testing and transplant service provision during the course of the pandemic and to provide actionable information highlighting advantages and drawbacks. To what extent can we preserve the noble purpose of transplantation in times of increased danger? Strategies to minimize risk exposure to the transplant population and health-workers include systematic virus screening, protection devices, social distancing and reduction of patients visits to the transplant center. While resources for the transplant activity are inevitably reduced, new dilemmas arise to the transplant community: further optimization of time constraints during organ retrievals and implantation, less organs and blood products donated, limited space in the intensive care unit and the duty to maintain safety and outcomes.

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Impact of COVID‐19 on liver transplantation in Europe: alert from an early survey of European Liver and Intestine Transplantation Association and European Liver Transplant Registry

Cited by 51 publications

References 15 publications

Outcomes of Coronavirus Disease 2019 in Living Donor Liver Transplant Recipients

Outcomes of Coronavirus Disease 2019 in Living Donor Liver Transplant Recipients

Post liver transplant recurrent and de novo viral infections

Transplantation during the COVID-19 pandemic: nothing noble is accomplished without danger

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