Liver transplant immunosuppression during the covid-19 pandemic. / Inmunosupresión en el trasplante hepático en la era covid-19.
Gastroenterol Hepatol
; 43(8): 457-463, 2020 Oct.
Artigo
em Inglês, Espanhol
| MEDLINE | ID: covidwho-639589
ABSTRACT
SARS-CoV-2 infection has produced a pandemic with serious consequences for our health care system. Although liver transplant patients represent only a minority of the population, the hepatologists who follow these patients have tried to coordinate efforts to produce a protocol the management of immunosuppression during SARS-CoV-2 infection. Although there are no solid studies to support general recommendations, experiences with other viral infections (hepatitis C, cytomegalovirus) suggest that management of immunosuppression without mycophenolate mofetil or m-Tor inhibitors (drugs that are also associated with leukopenia and lymphopenia) may be beneficial. It is also important to pay attention to possible drug interactions, especially in the case of tacrolimus, with some of the treatments with antiviral effect given in the context of COVID 19 (lopinavir/ritonavir, azithromycin). Finally, the immunosuppressive effect of immunomodulating drugs (tocilizumab and similar) administered to patients with severe lung disease should be taken into account. The mechanisms of action of the different immunosuppressive drugs are reviewed in this article, as well as their potential effect on SARS-CoV-2 infection, and suggests guidelines for the management of immunosuppression.
Palavras-chave
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Viral
/
Terapia de Imunossupressão
/
Transplante de Fígado
/
Infecções por Coronavirus
/
Pandemias
/
Betacoronavirus
/
Imunossupressores
Tipo de estudo:
Estudo observacional
/
Pesquisa qualitativa
Idioma:
Inglês
/
Espanhol
Revista:
Gastroenterol Hepatol
Ano de publicação:
2020
Tipo de documento:
Artigo
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