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QJM . Covid-19 in recipients of living donor liver transplantation: A worse or an equivalent outcome?

tetano

Editor, Senior Moderator
QJM


. 2021 Dec 28;hcab329.
doi: 10.1093/qjmed/hcab329. Online ahead of print.
Covid-19 in recipients of living donor liver transplantation: A worse or an equivalent outcome?


Manar Salah[SUP] 1 [/SUP], Hany M Dabbous[SUP] 1 [/SUP], Iman F Montasser[SUP] 1 [/SUP], Mohamed Bahaa[SUP] 2 [/SUP], Amr M Hilal Abdou[SUP] 3 [/SUP], Mahmoud S Elmeteini[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Coronavirus 2019(Covid-19) pandemic is representing a massive burden to the community with the new virus. There is few data regarding Covid -19 in liver transplant patients. Concerns were raised regarding the course of the disease in transplanted patients due to immunosuppression and risk of hepatic injuries.
Aim: To describe the outcomes of COVID-19 infection in recipients of living donor liver transplantation.
Methods: Retrospective analysis of forty-one recipients of living donor liver transplantation diagnosed with covid-19 by real time PCR or CT chest criteria of COVID 19 between April 2020 to April 2021. This Cohort was derived from Ain Shams Center for Organ Transplantation database, Ain Shams Specialized Hospital, Cairo, Egypt, which is considered one of the largest centers of LDLT in the Middle East. Patients were classified to mild, moderate, severe and critics according to clinical classification released by the National Health Commission of China.
Results: Forty-one (41) patients and 2 patients with reinfection were included in this cohort with mean age 54 y with 74% male and 26% female. The body mass index ranged from 19.3-37. Thirty (30%) percent were described as a mild case, 46.5% were moderate, 14% were severe and 9% were critical cases. Two cases developed infection twice. Twenty patients (46.5%) were managed in home isolation setting, 17 patients (39.5%) needed admission to ward, Four patients (9%) in intermediate care unit and Two patients (4%) admitted to intensive care unit (ICU).Sixty percent(60%) of cases were on room air, only 3 patients needed invasive methods, 2 patients needed face mask and one case needed invasive CPAP. Forty-one patients recovered (95%) and two patients (5%) died; one was Covid related and the other one was non-Covid related. Female gender, higher BMI and hypertension were associated with severe course of the disease.
Conclusion: In the setting of living donor liver transplantation, the possibilities of catching Covid-19 infection is high due to chronic immunosuppression use. Yet, the outcome of infection in term of morbidity and the needs for hospital admission or Intensive care is generally matched to general population.

Keywords: Body mass index; Corona virus disease; Egypt; Hypertension; Immunosuppression; Living donor liver transplantation.
 
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