Successful liver transplantation in patients with active SARS-CoV-2 infection

Mouch, Charles A.; Alexopoulos, Sophoclis P.; LaRue, Richard W.; Kim, Hannah P.

doi:10.1111/ajt.17134

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…To our knowledge, six SARS‐CoV‐2‐positive cases at the time of LT have been reported, which are summarized in Table 1, including our case 9,15–17 . Our patient was the only pediatric case, with the other five patients older than 18 years of age.…”

Section: Discussionmentioning

confidence: 74%

“…To our knowledge, six SARS-CoV-2-positive cases at the time of LT have been reported, which are summarized in Table 1, including our case. 9,[15][16][17] Our patient was the only pediatric case, with the other five patients older than 18 years of age. None of the reported cases had been treated with remdesivir before LT and COVID-19 convalescent plasma had been used in one case preoperatively.…”

Section: F I G U R E 1 Diagram Of Clinical Course In This Patient Inc...mentioning

confidence: 76%

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Successful pediatric liver transplantation case with a positive SARS‐CoV‐2 test at the time of transplant

Shimizu

Sakamoto

Yamada

et al. 2023

Hepatology Research

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Aim We report a successful liver transplantation (LT) in a child with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Case Presentation A 3‐year‐old female patient with decompensated cirrhosis due to Alagille syndrome underwent a split LT with a left lateral segment graft. She had a history of SARS‐CoV‐2 infection 4 months before LT. She was exposed to SARS‐CoV‐2 after the decision for organ acceptance. We repeatedly confirmed the negative SARS‐CoV‐2 test by polymerase chain reaction (PCR) before LT. Liver transplantation was carried out in the negative pressure operational theater with full airborne, droplet, and contact precautions as the patient was considered to be within the incubation period of SARS‐CoV‐2. The SARS‐CoV‐2 PCR test became positive in the nasopharyngeal swab specimen at the operation. Remdesivir, the antiviral treatment, was held off due to potential hepatotoxicity and no exacerbation of COVID‐19. She received tacrolimus and low‐dose steroids per protocol. She remained SARS‐CoV‐2 positive on postoperative days (PODs) 1, 2, and 5. The presence of antibodies for SARS‐CoV‐2 at LT was confirmed later. On POD 53, she was discharged without any symptomatic infection. Conclusion This case demonstrated that a positive SARS‐CoV‐2 result was not an absolute contraindication for a life‐saving LT. Liver transplantation could be safely performed in a pediatric patient with asymptomatic COVID‐19 and S‐immunoglobulin G antibodies for SARS‐CoV‐2.

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Section: Discussionmentioning

confidence: 74%

Section: F I G U R E 1 Diagram Of Clinical Course In This Patient Inc...mentioning

confidence: 76%

Successful pediatric liver transplantation case with a positive SARS‐CoV‐2 test at the time of transplant

Shimizu

Sakamoto

Yamada

et al. 2023

Hepatology Research

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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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“…As time goes by, LT's activities are proceeding in an orderly manner. One positive SARS‐CoV‐2 LT in a patient with acute liver failure due to Wilson crisis has been successfully performed, and other studies have shown that LT surgery in positive patients can be performed after safety assessment 77,78 …”

Section: Influence Of Liver Disease To Covid‐19mentioning

confidence: 99%

COVID‐19‐associated liver injury: Adding fuel to the flame

Wang,

Shen,

et al. 2023

Cell Biochemistry & Function

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COVID‐19 is mainly characterized by respiratory disorders and progresses to multiple organ involvement in severe cases. With expansion of COVID‐19 and SARS‐CoV‐2 research, correlative liver injury has been revealed. It is speculated that COVID‐19 patients exhibited abnormal liver function, as previously observed in the SARS and MERS pandemics. Furthermore, patients with underlying diseases such as chronic liver disease are more susceptible to SARS‐CoV‐2 and indicate a poor prognosis accompanied by respiratory symptoms, systemic inflammation, or metabolic diseases. Therefore, COVID‐19 has the potential to impair liver function, while individuals with preexisting liver disease suffer from much worse infected conditions. COVID‐19 related liver injury may be owing to direct cytopathic effect, immune dysfunction, gut−liver axis interaction, and inappropriate medication use. However, discussions on these issues are infancy. Expanding research have revealed that angiotensin converting enzyme 2 (ACE2) expression mediated the combination of virus and target cells, iron metabolism participated in the virus life cycle and the fate of target cells, and amino acid metabolism regulated immune response in the host cells, which are all closely related to liver health. Further exploration holds great significance in elucidating the pathogenesis, facilitating drug development, and advancing clinical treatment of COVID‐19‐related liver injury. This article provides a review of the clinical and laboratory hepatic characteristics in COVID‐19 patients, describes the etiology and impact of liver injury, and discusses potential pathophysiological mechanisms.

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Successful liver transplantation in patients with active SARS-CoV-2 infection

Cited by 8 publications

References 15 publications

Successful pediatric liver transplantation case with a positive SARS‐CoV‐2 test at the time of transplant

Successful pediatric liver transplantation case with a positive SARS‐CoV‐2 test at the time of transplant

COVID-19: Has the Liver Been Spared?

COVID‐19‐associated liver injury: Adding fuel to the flame

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