Living Donor Liver Transplantation During the COVID-19 Pandemic: an Evolving Challenge

Bhatti, Abu Bakar Hafeez; Nazish, Malka; Khan, Nusrat Yar; Manan, Fazal; Zia, Haseeb; Ilyas, Abid; Ishtiaq, Wasib; Khan, Nasir

doi:10.1007/s11605-021-05057-3

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…This can be attributed to the impact of COVID-19. Access to hospitals, healthcare professionals, and transportation was difficult during this time [ 29 ]. As a result, we kept a lower threshold for re-admission after LLD.…”

Section: Discussionmentioning

confidence: 99%

Textbook outcome among voluntary donors undergoing major living donor hepatectomy

Bhatti

Naqvi

Ali

et al. 2022

Langenbecks Arch Surg

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Purpose Textbook outcome (TO) is a composite measure of outcome and provides superior assessment of quality of care after surgery. TO after major living donor hepatectomy (MLDH) has not been assessed. The objective of this study was to determine the rate of TO and its associated factors, after MLDH. Methods This was a single center retrospective review of living liver donors who underwent MLDH between 2012 and 2021 ( n = 1022). The rate of TO and its associated factors was determined. Results Among 1022 living donors (of whom 693 [67.8%] were males, median age 26 [range, 18–54] years), TO was achieved in 714 (69.9%) with no donor mortality. Majority of donors met the cutoffs for individual outcome measures: 908 (88.8%) for no major complications, 904 (88.5%) for ICU stay ≤ 2 days, 900 (88.1%) for hospital stay ≤ 10 days, 990 (96.9%) for no perioperative blood transfusion, 1004 (98.2%) for no 30-day re-admission, and 1014 (99.2%) for no post-hepatectomy liver failure. Early donation era (before streamlining of donor operative pathways) was associated with failure to achieve TO [OR 1.4, CI 1.1–1.9, P = 0.006]. TO was achieved in 506/755 (67%) donors in the early donation era versus 208/267 (77.9%) in the later period ( P = 0.001). Conclusion Despite zero mortality and low complication rate, TO was achieved in approximately 70% donors. TO was modifiable and improved with changes in donor operative pathway.

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Section: Discussionmentioning

confidence: 99%

Textbook outcome among voluntary donors undergoing major living donor hepatectomy

Bhatti

Naqvi

Ali

et al. 2022

Langenbecks Arch Surg

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“…Georgiades et al (2021) 13 Saracco et al (2021) 30 Balsara et al (2021) 24 Karolak et al (2021) 15 Boedecker et al (2021) 31 Soin et al (2021) 48 Halpern et al (2020) 23 Sahin et al (2022) 33 Bhatti et al (2021) 54 Dogar et al (2021) 26 Araújo et al (2020) 35 Cristelli et al (2021) 55 Varma et al (2021) 27 Muller et al (2020) 37 Caliskan et al (2021) 56 Simone et al (2020) 28 Xu et al (2021) 38 Cheung et al (2021) 61 Pestana et al (2021) 29 Hudgins et al (2021) 45 4 Watschinger et al (2020) 22 Bordes et al (2020) 52 Chew et al (2020) 5 Ashfaq et al (2021) 25 Hardman et al (2021) 53 Boyarsky et al (2020) 6 Anderson et al (2021) 32 9 Couzi et al (2021) 39 Ravanan et al (2020) 60 Reddy et al (2020) 10 Peters et al (2021) 40 Varghese et al (2021) 63 Benvenuto et al (2021) 11 Vries et al (2020) 41 Cristelli et al (2022) 64 Kemme et al (2021) 12 Goff et al (2021) 42 Doshi et al (2021) 65 Belli et al (2021) 14 Immer et al (2020) 43 Strauss et al (2020) 66 Sharma et al (2020)…”

Section: Monocêntricomentioning

confidence: 99%

Impacto na Fila de Espera dos Transplantes de Órgãos Sólidos Durante a Pandemia de Covid-19: Uma Revisão Integrativa

Costa,

Furtado,

Braga

et al. 2023

BJT

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Introdução: Com a pandemia da Covid-19, muitos procedimentos médicos sofreram alterações significativas devido à realocação de recursos para os pacientes contaminados pelo Sars-Cov-2. A logística de transplantes foi diretamente afetada, com repercussões importantes para o paciente na fila de espera para um novo órgão. Objetivo: Esta revisão busca analisar o impacto da pandemia da Covid-19 na logística de disponibilidade de órgãos sólidos e volume de transplantes. Métodos: Foi realizada uma busca integrativa de artigos com os descritores “Covid OR Sars-Cov-2”, “COVID-19”, “Transplant”, “Donor”, “Waiting list”, “Organ donation” no PubMed e Web of Science. Só foram considerados artigos sobre transplante de pâncreas, coração, fígado, rim e intestino, e que abordassem um dos seguintes tópicos: disponibilidade de doadores, volume e tempo na lista de espera, mortalidade dos pacientes em espera, volume de transplantes realizados. Resultados: Dos 68 artigos encontrados, 49 deles eram multicêntricos. Dentre todos os 68, 29 fizeram alguma colocação em relação ao volume de doador, 42 em relação ao volume de transplante, 18 em relação à mortalidade na fila de transplante, 15 em relação ao volume da lista de espera e quatro em relação ao tempo na lista de espera. Com tais dados, de forma geral, foi possível observar diminuição do volume de doadores e do volume de transplantes, redução de adições à lista de espera, e aumento tanto no tempo de espera para transplantes, quanto na mortalidade do paciente que aguardava pelo transplante. Conclusão: A pandemia da SARS-CoV-2 prejudicou diretamente a logística dos transplantes de órgãos sólidos de forma global. Os motivos que levaram a tal fato estão relacionados à diminuição dos leitos de UTI, contaminação do doador pelo vírus, e protocolos rigorosos para prevenção de transmissibilidade do vírus.

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“…Globally, solid organ transplantation has been profoundly affected by the COVID-19 pandemic, resulting in decreased rates of organ procurement and transplantation[ 80 , 81 ]. Liver is the second most common solid organ transplanted in the world after kidney[ 82 ].…”

Section: Solid Organ Transplantsmentioning

confidence: 99%

Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective

Hanif¹,

Majid²,

Ahmed³

et al. 2022

World J Virol

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The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has become a global challenge of unprecedented nature since December 2019. Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement, in approximately 5%-10% of patients, the disease is severe and involves multiple organs, leading to multi-organ dysfunction and failure. The liver and gastrointestinal tract are also frequently involved in COVID-19. In the context of liver involvement in patients with COVID-19, many key aspects need to be addressed in both native and transplanted organs. This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease, patients with pre-existing liver diseases and liver transplant recipients. A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.

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Living Donor Liver Transplantation During the COVID-19 Pandemic: an Evolving Challenge

Cited by 9 publications

References 24 publications

Textbook outcome among voluntary donors undergoing major living donor hepatectomy

Textbook outcome among voluntary donors undergoing major living donor hepatectomy

Impacto na Fila de Espera dos Transplantes de Órgãos Sólidos Durante a Pandemia de Covid-19: Uma Revisão Integrativa

Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective

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