Liver transplant after SARS-CoV-2 infection: A systematic review

Nacif, Lucas Souto; Fernandes, Michel Ribeiro; Waisberg, Daniel Reis; Pinheiro, Rafael Soares; Rocha-Santos, Vinícius; Galvão, Flávio Henrique Ferreira; Andraus, Wellington; D’Albuquerque, Luiz Augusto Carneiro

doi:10.1016/j.clinsp.2022.100042

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…It is suggested that the transplant should be performed with one negative COVID-19 reverse transcription-PCR test 24 h prior to the transplantation[ 139 ]. It was found that COVID-19 infection before liver transplantation in patients with high MELD scores was not associated with a higher mortality rate[ 140 ]. As a result, postponing the surgery to a later time than what is suggested above is not recommended.…”

Section: Outcome Management and Considerations In Special Populationsmentioning

confidence: 99%

COVID-19 and liver injury: Pathophysiology, risk factors, outcome and management in special populations

Roshanshad¹,

Roshanshad²,

Fereidooni³

et al. 2023

World J Hepatol

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The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 is an ongoing health concern. In addition to affecting the respiratory system, COVID-19 can potentially damage other systems in the body, leading to extra-pulmonary manifestations. Hepatic manifestations are among the common consequences of COVID-19. Although the precise mechanism of liver injury is still questionable, several mechanisms have been hypothesized, including direct viral effect, cytokine storm, hypoxic-ischemic injury, hypoxia-reperfusion injury, ferroptosis, and hepatotoxic medications. Risk factors of COVID-19-induced liver injury include severe COVID-19 infection, male gender, advanced age, obesity, and underlying diseases. The presentations of liver involvement comprise abnormalities in liver enzymes and radiologic findings, which can be utilized to predict the prognosis. Increased gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase levels with hypoalbuminemia can indicate severe liver injury and anticipate the need for intensive care units’ hospitalization. In imaging, a lower liver-to-spleen ratio and liver computed tomography attenuation may indicate a more severe illness. Furthermore, chronic liver disease patients are at a higher risk for severe disease and death from COVID-19. Nonalcoholic fatty liver disease had the highest risk of advanced COVID-19 disease and death, followed by metabolic-associated fatty liver disease and cirrhosis. In addition to COVID-19-induced liver injury, the pandemic has also altered the epidemiology and pattern of some hepatic diseases, such as alcoholic liver disease and hepatitis B. Therefore, it warrants special vigilance and awareness by healthcare professionals to screen and treat COVID-19-associated liver injury accordingly.

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Section: Outcome Management and Considerations In Special Populationsmentioning

confidence: 99%

COVID-19 and liver injury: Pathophysiology, risk factors, outcome and management in special populations

Roshanshad¹,

Roshanshad²,

Fereidooni³

et al. 2023

World J Hepatol

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“…One recent review studied liver transplant outcomes in patients with high MELD or fulminant hepatitis diagnosed with COVID-19 just prior to transplant (median 19 days before initiation), and found no increase in mortality compared to normal transplant patients. 47 Routine screening for COVID-19 is recommended in both donors and recipients. Although transplant is contraindicated in the setting of active infection, patients can be considered for liver transplantation 14–21 days after the initial infection, particularly if repeat testing is negative.…”

Section: Liver Transplantation and Covid-19mentioning

confidence: 99%

“… 48 Mycophenolate mofetil, on the other hand, is an independent predictor of severe COVID-19 in liver transplant recipients. 47 As such, optimal management regarding immunosuppression in the setting of COVID-19 is unclear. Reducing the overall level of immunosuppression is reasonable in post-transplant recipients with COVID-19 infection.…”

Section: Liver Transplantation and Covid-19mentioning

confidence: 99%

COVID-19-Associated Liver Injury

Gildea¹,

Woo²,

O'Connor³

et al. 2023

HMER

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This review analyzes data regarding liver injury associated with COVID-19 infection. We discuss reported effects on the liver from both COVID-19 and COVID-19 treatment as well as pathophysiology, review the potential role of drug-induced liver injury as an etiology of COVID-19-associated liver injury, and touch on other reports of significant outcomes including COVID-19 cholangiopathy and autoimmune hepatitis. Finally, we review the implications of COVID-19 infection in liver transplant recipients.

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