The impact of Coronavirus 19 disease on liver transplantation in France: The sickest first approach?

Mazzola, Alessandra; Kerbaul, François; Atif, Muhammad; Monsel, Antoine; Malaquin, Géraldine; Pourcher, Valérie; Scatton, Olivier; Conti, Filoména

doi:10.1016/j.clinre.2020.06.007

Cited by 3 publications

(5 citation statements)

References 1 publication

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“…However, this sickest-first approach poses the risk of prolonged hospital stays for such patients, thus conversely increasing the ICU length of stay[ 12 ]. For this reason, some centers have temporarily suspended treating aging patients with comorbidities and surgical complexities to minimize the chance of complications[ 10 , 13 , 14 ]. Likewise, different centers have reduced the use of marginal grafts and those from donation after circulatory death for both fear of poor transplant outcomes and heavier commitment on ICU personnel[ 3 , 15 , 16 ].…”

Section: Trends In Organ Donation and Transplant Activity During The mentioning

confidence: 99%

“…However, their use is hotly debated for super-urgent patients. Some authors have suggested that for selected patients with imminently life-threatening organ failure, transplants from deceased donors with asymptomatic or mild SARS-CoV-2 infection may offer a favorable risk-benefit balance[ 14 , 28 , 29 ]. The two main arguments in favor of this position were as follows:…”

Section: Transplant-related Transmission and Utilization Of Covid-posmentioning

confidence: 99%

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

Carlis

Vella

Incarbone

et al. 2021

WJG

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The coronavirus disease 2019 (COVID-19) pandemic has upended healthcare systems worldwide and led to an inevitable decrease in liver transplantation (LT) activity. During the first pandemic wave, administrators and clinicians were obliged to make the difficult decision of whether to suspend or continue a life-saving procedure based on the scarce available evidence regarding the risk of transmission and mortality in immunosuppressed patients. Those centers where the activity continued or was heavily restricted were obliged to screen donors and recipients, design COVID-safe clinical pathways, and promote telehealth to prevent nosocomial transmission. Despite the ever-growing literature on COVID-19, the amount of high-quality literature on LT remains limited. This review will provide an updated view of the impact of the pandemic on LT programs worldwide. Donor and recipient screening, strategies for waitlist prioritization, and posttransplant risk of infection and mortality are discussed. Moreover, a particular focus is given to the possibility of donor-to-recipient transmission and immunosuppression management in COVID-positive recipients.

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Section: Trends In Organ Donation and Transplant Activity During The mentioning

confidence: 99%

Section: Transplant-related Transmission and Utilization Of Covid-posmentioning

confidence: 99%

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

Carlis

Vella

Incarbone

et al. 2021

WJG

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“…The Federal District alone performed more than 20 transplants per million population (pmp) 9 . Similarly to Brazil, data from France and the USA also showed a reduced number of liver transplantations during the COVID-19 pandemic, in 2020 14 , 23 , 24 .…”

Section: Discussionmentioning

confidence: 94%

“…The National Transplant Agency (ABM) and the Public Health Council (HCSP) started to recommend the screening of all donors in order to analyze the risk-benefit ratio to approve transplants. Consequently, the applied analysis to data in the second half of March 2019 showed approximately 60 liver transplants, which decreased to approximately 20 transplants in the same period in 2020 23 .…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the number of transplants performed in Brazil during the pandemic. Current situation

Ribeiro-Júnior

Costa

Néder

et al. 2021

Rev. Col. Bras. Cir.

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The intense use of resources to combat COVID-19 causes concern in the entire transplant community because, in addition to physical limitations such as ICU beds, lack of homogeneous treatment protocols and uncertainties about the effects of immunosuppression on viral progression have significant impact on transplant surgeries. The aim of the present study is to comparatively assess the number of solid organ transplants performed in 2019 and 2020, as well as the impact of the COVID-19 pandemic on organ donation and transplant surgeries in Brazil. The last 10 years have shown increasing trend in the number of solid organ transplants, which have significantly decreased in 2020. Lung transplantations were mostly affected by the pandemic; these surgeries have been carried out only in Rio Grande do Sul and São Paulo states. Liver transplantations were the least affected ones, since the number of surgeries have only decreased by 10.8% in the first three quarters of 2020, in comparison to 2019. The number of active patients on the waiting list for heart and kidney transplantation has increased in 2020. Therefore, it is necessary developing strategies to keep the structure necessary for organ transplantation processes active and, consequently, to reduce the impacts of the pandemic on these patients.

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“…There have also been few reports of successful liver transplantation in individuals with asymptomatic or mild symptomatic COVID-19 infection without developing postoperative COVID-19 symptoms [ 200 , 201 , 202 , 203 ]. However, the decision to proceed with transplantation in this high-risk population must be balanced by the urgency of the procedure against potential COVID-19-associated perioperative risks; therefore, ideally, transplantation should always be deferred until acute COVID-19 infection is resolved.…”

Section: Covid-19 In Patients With Pre-existing Chronic Liver Diseasementioning

confidence: 99%

COVID-19: Has the Liver Been Spared?

Brandi

Spinelli

Granito

et al. 2023

IJMS

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The liver is a secondary and often collateral target of COVID-19 disease but can lead to important consequences. COVID-19 might directly cause a high number of complications in patients with pre-existing chronic liver disease, increasing their risk of hepatic decompensation. Moreover, it also determines indirect consequences in the management of patients with liver disease, especially in those suffering from decompensated cirrhosis and HCC, as well as in the execution of their follow-up and the availability of all therapeutic possibilities. Liver imaging in COVID-19 patients proved to be highly nonspecific, but it can still be useful for identifying the complications that derive from the infection. Moreover, the recent implementation of telemedicine constitutes a possible solution to both the physical distancing and the re-organizational difficulties arising from the pandemic. The present review aims to encompass the currently hypothesized pathophysiological mechanisms of liver injury in patients with COVID-19 mediated by both the direct invasion of the virus and its indirect effects and analyze the consequence of the pandemic in patients with chronic liver disease and liver tumors, with particular regard to the management strategies that have been implemented to face this worldwide emergency and that can be further improved.

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The impact of Coronavirus 19 disease on liver transplantation in France: The sickest first approach?

Cited by 3 publications

References 1 publication

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

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

Impact of COVID-19 on the number of transplants performed in Brazil during the pandemic. Current situation

COVID-19: Has the Liver Been Spared?

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