Successful liver transplantation in a patient recovered from COVID-19

Transpl Infect Dis. 2021 Apr;23(2):e13492. doi: 10.1111/tid.13492. Epub 2020 Oct 22.

Abstract

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.

Keywords: COVID-19; coronavirus; liver transplantation.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Antilymphocyte Serum / therapeutic use
  • COVID-19 / complications
  • COVID-19 / therapy*
  • COVID-19 Serotherapy
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / surgery*
  • Glucocorticoids / therapeutic use
  • Graft Rejection / drug therapy
  • Graft Rejection / prevention & control*
  • Hepatitis, Alcoholic / complications
  • Hepatitis, Alcoholic / surgery*
  • Humans
  • Immunization, Passive
  • Immunosuppressive Agents / therapeutic use*
  • Liver Transplantation*
  • Male
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Antilymphocyte Serum
  • Glucocorticoids
  • Immunosuppressive Agents
  • thymoglobulin