Management of COVID-19 in Liver Transplant Recipients With Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry

Sheikhalipour, Zahra; Kermani, Touraj Asvadi; Kakaei, Farzad; Khalili, Azizeh Farshbaf; Vahedi, Leila

doi:10.6002/ect.2020.0526

Cited by 2 publications

(1 citation statement)

References 21 publications

(42 reference statements)

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“…For fear of organ rejection, the patients’ immunosuppressive regimens were only slightly modified, with mycophenolate mofetil (MMF) dose being reduced to limit liver enzyme level elevation. While previous studies have argued in favor of lowering immunosuppression during COVID-19, Sheikhalipour et al [ 21 ], among others, have shown that despite minimal alterations in the patients’ immunosuppressive regimen, most participants fully recovered from COVID-19[ 22 ]. Ethical considerations regarding the risk of acute rejection following a significant reduction in the immunosuppressive regimen make randomized control trials investigating the role of immunosuppression discontinuation or decrease in the setting of COVID-19 inherently challenging.…”

Section: Immunosuppression and Covid-19 In Liver Transplant Recipientsmentioning

confidence: 99%

Liver transplantation during COVID-19: Adaptive measures with future significance

Gyftopoulos¹,

Ziogas²,

Montenovo³

2022

WJT

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Following the outbreak of coronavirus disease 2019 (COVID-19), a disease caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the field of liver transplantation, along with many other aspects of healthcare, underwent drastic changes. Despite an initial increase in waitlist mortality and a decrease in both living and deceased donor liver transplantation rates, through the implementation of a series of new measures, the transplant community was able to recover by the summer of 2020. Changes in waitlist prioritization, the gradual implementation of telehealth, and immunosuppressive regimen alterations amidst concerns regarding more severe disease in immunocompromised patients, were among the changes implemented in an attempt by the transplant community to adapt to the pandemic. More recently, with the advent of the Pfizer BNT162b2 vaccine, a powerful new preventative tool against infection, the pandemic is slowly beginning to subside. The pandemic has certainly brought transplant centers around the world to their limits. Despite the unspeakable tragedy, COVID-19 constitutes a valuable lesson for health systems to be more prepared for potential future health crises and for life-saving transplantation not to fall behind.

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Section: Immunosuppression and Covid-19 In Liver Transplant Recipientsmentioning

confidence: 99%

Liver transplantation during COVID-19: Adaptive measures with future significance

Gyftopoulos¹,

Ziogas²,

Montenovo³

2022

WJT

View full text Add to dashboard Cite

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Clinical Manifestations and Characterization of COVID-19 in Liver Transplant Recipients: A Systematic Review of Case Reports and Case Series

Samidoust¹,

Nikoupour²,

Hemmati³

et al. 2021

Ethiop J Health Sci

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BACKGROUND፡ This systematic review is conducted to explore available information on clinical presentations, laboratory finding and outcomes of SARS-COV-2 in liver transplant patients.METHODS: We searched four databases for relevant terms related to COVID-19 and liver transplantation and collected both case reports and case series on liver transplantation published up to the end of September 2020.RESULTS: After initial screening of irrelevant articles, 25 studies were included and analyzed in this review. Among the 59 patients included,78.3% were over 50 years old, and 71.6% were males. The majority of patients (93.3%) were hospitalized. The most common presenting symptoms were fever (72.9%) followed by dyspnea and cough (54.2%). The majority of patients revealed a high level of CRP (64.3%). Moreover, high level ALT, AST and ALP were reported in 64.3, 37.5, 30.5 and 22.2% of patients. A total, 9(15.3%), of cases died as a result of complications of COVID-19. Chest radiographs were reported in 72.9%(43/59) of cases that 94% demonstrated radiologic evidence of abnormality.CONCLUSION: The results demonstrated that the most prevalent symptoms and signs were fever, dyspnea and cough. Moreover, most patients were males and hospitalized. The rate of mortality and high level of CRP, ALT/AST and ALP is similar within the non-immune suppressed and general population. However, early detection of high level of serum CRP, ALT/AST and ALP combined with a clinical COVID-19 symptom and finding of CT scan may be used as an index for the presence and severity of the disease.

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Management of COVID-19 in Liver Transplant Recipients With Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry

Cited by 2 publications

References 21 publications

Liver transplantation during COVID-19: Adaptive measures with future significance

Liver transplantation during COVID-19: Adaptive measures with future significance

Clinical Manifestations and Characterization of COVID-19 in Liver Transplant Recipients: A Systematic Review of Case Reports and Case Series

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