Transplantation in potential candidates who have recently recovered from COVID‐19 is a challenge with uncertainties regarding the diagnosis, multi‐organ systemic involvement, prolonged viral shedding in immunocompromised patients, and optimal immunosuppression. A 42 year male with alcoholic hepatitis underwent a successful deceased donor liver transplantation 71 days after the initial diagnosis of COVID‐19. At the time of transplant, he was SARS‐CoV‐2 PCR negative for 24 days and had a MELD score of 33. His post‐operative course was complicated by acute rejection which responded to intense immune‐suppression using T‐cell depletion and steroids. He was discharged with normal end‐organ function and no evidence of any active infection including COVID‐19. Prospective organ transplant recipients who have recovered from COVID‐19 can be considered for transplantation after careful pre‐transplant evaluation, donor selection, and individualized risk‐benefit analysis.
Directly observed 3HP LTBI treatment was not associated with hepatotoxicity, even in patients with higher MELD scores. Further studies are needed to confirm the safety and efficacy of this LTBI treatment regimen in the SOT population.
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