Recurrent hepatic artery thrombosis following living donor liver transplant as sequelae of SARS-CoV-2 infection: case report

Raj, Anupam; Shankar, Vijay; Singhal, Saurabh; Goyal, Neerav; Arunkumar, Venuthurimilli; Garg, Hitendra

doi:10.21203/rs.3.rs-497240/v1

Cited by 3 publications

(4 citation statements)

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“…In general, there have been no obvious COVID-19 related complications in the follow-up of these cases. However, there are reports of portal venous thrombosis and hepatic artery thrombosis in two DDLT transplanted to COVID-19 recovered patients [45,46]. Although the association of this complication with COVID-19 is not clearly delineated, it raises a word of caution.…”

Section: Liver Transplantation After Recovery From Covid-19mentioning

confidence: 99%

Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature

et al. 2022

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Purpose of Review As the coronavirus disease 2019 (COVID-19) pandemic continues to surge, determining the safety and timing of proceeding with solid organ transplantation (SOT) in transplant candidates who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and who are otherwise transplant eligible is an important concern. We reviewed the current status of protocols and the outcomes of SOT in SARS-CoV-2 recovered patients. Recent Findings We identified 44 published reports up through 7 September 2021, comprising 183 SOT [kidney = 115; lung = 27; liver = 36; heart = 3; simultaneous pancreas-kidney (SPK) = 1, small bowel = 1] transplants in SARS-CoV-2 recovered patients. The majority of these were living donor transplants. A positive SARS-CoV-2 antibody test, although not obligatory in most reports, was a useful tool to strengthen the decision to proceed with transplant. Two consecutive real-time polymerase chain test (RT-PCR) negative tests was one of the main prerequisites for transplant in many reports. However, some reports suggest that life-saving transplantation can proceed in select circumstances without waiting for a negative RT-PCR. In general, the standard immunosuppression regimen was not changed. Summary In select cases, SOT in COVID-19 recovered patients appears successful in short-term follow-up. Emergency SOT can be performed with active SARS-CoV-2 infection in some cases. In general, continuing standard immunosuppression regimen may be reasonable, except in cases of inadvertent transplantation with active SARS-CoV-2. Available reports are predominantly in kidney transplant recipients, and more data for other organ transplants are needed.

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Section: Liver Transplantation After Recovery From Covid-19mentioning

confidence: 99%

Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature

et al. 2022

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“…Several case reports have shown that HAT can happen as a consequence of the infection 11 15. A recurrent form of HAT as a result of COVID-19 was reported in India, which shows the severity of HAT by which the cases might be affected 16…”

Section: Discussionmentioning

confidence: 99%

“…ever since the first studies of COVID-19 were carried out, it was realised that the infection increases coagulopathic incidences such as stroke 13 14. Even though several cases of post-transplantation HAT have been reported, the correlation between the two incidences have not been studied 15 16…”

Section: Introductionmentioning

confidence: 99%

Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre

Moradi

Hadizadeh

Ghiasvand

et al. 2023

BMJ Open Gastroenterol

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BackgroundLiver transplantation is a proven management method for end-stage cirrhosis and is estimated to have increased life expectancy by 15 years. The COVID-19 pandemic posed a challenge to patients who were candid for a solid-organ transplant. It has been suggested that the outcomes of liver transplants could be adversely affected by the infection, as immunosuppression makes liver transplant candidates more susceptible to adverse effects while predisposing them to higher thrombotic events.Material and methodsIn this retrospective study, the cases who received liver transplants from January 2018 to March 2022 were assessed regarding early postoperative mortality rate and hepatic artery thrombosis (HAT) with COVID-19 infection. This study included 614 cases, of which 48 patients were infected.ResultsThis study shows that the early COVID-19-related early postoperative mortality rates substantially increased in the elective setting (OR: 2.697), but the results for the acute liver failure were insignificant. The average model for end-stage liver disease score increased significantly during the pandemic due to new regulations. Although mortality rates increased during the pandemic, the data for the vaccination period show that mortality rates have equalised with the prepandemic era. Meanwhile, COVID-19 infection is assumed to have increased HAT by 1.6 times in the elective setting.ConclusionThis study shows that COVID-19 infection in an acute liver failure poses comparatively little risk; hence transplantation should be considered in such cases. Meanwhile, the hypercoagulative state induced by the infection predisposes this group of patients to higher HAT rates.

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“…Cases of successful liver transplants 2–4 weeks after infection have been anecdotally reported early in the pandemic but are likely to become more frequent given occurrence of reinfections [65]. Some concerns persist regarding hypercoagulable state and risk of arterial thrombosis [66]. When a candidate is found to be positive, serial cycle threshold (Ct) values can be used as a tool to time infection, with Ct values above 32–34 being a marker of low infectivity and potentially lower surgical or complication risk [67].…”

Section: Covid-19 Infected Donors and Recipientsmentioning

confidence: 99%

Update on Covid-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors

Boutin

Alamri

Ison

2023

Current Opinion in Organ Transplantation

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Purpose of review SARS-CoV-2 resulted in a global pandemic that had a chilling effect on transplantation early in the pandemic and continues to result in significant morbidity and mortality of transplant recipients. Over the past 2.5 years, our understanding of the clinical utility of vaccination and mAbs to prevent COVID-19 in solid organ transplant (SOT) recipients has been studied. Likewise, approach to donors and candidates with SARS-CoV-2 has been better understood. This review will attempt to summarize our current understanding of these important COVID-19 topics. Recent findingsVaccination against SARS-CoV-2 is effective in reducing the risk of severe disease and death among transplant patients. Unfortunately, humoral and, to a lesser extent, cellular immune response to existing COVID-19 vaccines is reduced in SOT recipients compared with healthy controls. Additional doses of vaccine are required to optimize protection of this population and still may be insufficient in those who are highly immunosuppressed, those receiving belatacept, rituximab and other B-cell active mAbs. Until recently, mAbs were options for the prevention of SARS-CoV-2 but are markedly less effective with recent omicron variants. SARS-CoV-2-infected donors can generally be used for nonlung, nonsmall bowel transplants unless they have died of acute severe COVID-19 or COVID-19-associated clotting disorders. SummaryOur transplant recipients require a three-dose mRNA or adenovirus-vector and one dose of mRNA vaccine to be optimally protected initially; they then need to receive a bivalent booster 2þ months after completing their initial series. Most nonlung, nonsmall bowel donors with SARS-CoV-2 can be utilized as organ donors.

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Recurrent hepatic artery thrombosis following living donor liver transplant as sequelae of SARS-CoV-2 infection: case report

Cited by 3 publications

References 4 publications

Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature

Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature

Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre

Update on Covid-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors

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