Early liver transplantation after COVID-19 infection: The first report

Am J Transplant. 2021 Jun;21(6):2279-2284. doi: 10.1111/ajt.16509. Epub 2021 Feb 15.

Abstract

COVID-19 (coronavirus disease 2019) has impacted solid organ transplantation (SOT) in many ways. Transplant centers have initiated SOT despite the COVID-19 pandemic. Although it is suggested to wait for 4 weeks after COVID-19 infection, there are no data to support or refute the timing of liver transplant after COVID-19 infection. Here we describe the course and outcomes of COVID-19-infected candidates and healthy living liver donors who underwent transplantation. A total of 38 candidates and 33 potential living donors were evaluated from May 20, 2020 until October 30, 2020. Ten candidates and five donors were reverse transcriptase-polymerase chain reaction (RT-PCR) positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pretransplant. Four candidates succumbed preoperatively. Given the worsening of liver disease, four candidates underwent liver transplant after 2 weeks due to the worsening of liver disease and the other two candidates after 4 weeks. Only one recipient died due to sepsis posttransplant. Three donors underwent successful liver donation surgery after 4 weeks of COVID-19 infection without any postoperative complications, and the other two were delisted (as the candidates expired). This report is the first to demonstrate the feasibility of elective liver transplant early after COVID-19 infection.

Keywords: clinical research/practice; infection and infectious agents; liver transplantation/hepatology; liver transplantation: living donor.

Publication types

  • Case Reports

MeSH terms

  • COVID-19*
  • Humans
  • Liver Transplantation*
  • Organ Transplantation*
  • Pandemics
  • SARS-CoV-2
  • Transplant Recipients