ABSTRACT
Abstract
Background:
The
Coronavirus 19 (COVID-19)
pandemic has dramatically impacted
liver organ transplantation. The American Society of
Transplantation recommends a minimum of 28 days after symptom resolution for
organ donation. However, the exact
time for
transplantation for recipients is unknown. Considering that
mortality on the
waiting list for
patients with MELD >25 or
fulminant hepatitis is higher than that of COVID-19, the best
time for
surgery after SARS-CoV-2 infection remains undetermined. This study aims to expand the current
knowledge regarding the
Liver Transplantation (LT)
time for
patients after COVID-19 and to provide
transplant physicians with essential
decision-making tools to manage these
critically ill patients during the
pandemic.
Methods:
Systematic review of
patients who underwent
liver transplantation after
diagnosis of COVID-19. The
MEDLINE,
PubMed, Cochrane,
Lilacs, Embase, and Scielo databases were searched until June 20, 2021. The MESH terms used were "COVID-19" and "
Liver transplantation".
Results:
558 articles were found; of these 13 articles and a total of 18 cases of COVID-19 prior to
liver transplantation were reported. The mean age was 38.7±14.6, with
male prevalence. Most had mild symptoms of COVID. Five
patients have specific
treatment for COVID-19 with convalescent plasm or remdesivir/
oseltamivir, just one
patient received
hydroxychloroquine, and 12
patients received only symptomatic
treatment. The median
time between COVID-19 to LT was 19 days (13.5-44.5). Deceased
donor liver transplantation accounted for 61% of cases, while
living donor transplantation was 39%.
Conclusion:
Despite the concerns regarding the postoperative evolution, the
mortality of
patients with high MELD or
fulminant hepatitis transplanted shortly after COVID-19
diagnosis does not seem to be higher. (PROSPERO, registration number = CRD42021261790)