Clinical study of novel coronaviral infection in recipients of liver transplantation from deceased donation / 中华器官移植杂志

ABSTRACT

Objective:To explore the effects of novel coronaviral infection on the outcomes of liver transplantation recipients.Methods:The relevant clinical data were retrospectively reviewed for 5 liver transplantation recipients infected with novel coronavirus during perioperative period at First Hospital of Shanxi Medical University.At the same time, "liver transplantation" and "novel coronavirus" and "2019 novel coronavirus" or "SARS-CoV-2" were employed as Chinese and English keywords respectively for searching the relevant literature items of CNKI, Wanfang and PubMed from the inception of database until February 2023.The impact of perioperative novel coronaviral infection was examined on the outcomes of liver transplantation recipients.Results:From November 2022 to January 2023, liver transplantation was performed in 5 recipients of donated liver after death.Two cases tested positive for real-time polymerase chain reaction(RT-PCR)at Day 14/20 pre-operation and converted into negative post-operation.Three cases were infected with SARS-CoV-2 at Day 1/10/16 post-operation.And one of them became feverish again at Day 11 post-infection.With a peak temperature of 39.5 degrees, it rapidly progressed into multiple organ failures of heart, lung and kidney.After active interventions, organ function gradually recovered.Through literature searches, 9 eligible English literature items were retrieved.However, there was no Chinese entry.Among 15 liver transplantation recipients with SARS-CoV-2 infection, one died from septic shock, another from graft failure and the remainders survived.Conclusions:liver transplantation recipients infected with SARS-CoV-2 and negative RT-PCR pre-operation are asymptomatic.Without signs of pneumonia on chest CT, transplantation may be performed.For post-liver transplantation recipients with early SARS-CoV-2 infection, close monitoring of important organ functions such as heart, lung, liver and kidney, timely antiviral regimen and tapered use of immunosuppression can achieve a decent prognosis.