Table 2.
Liver transplantation in candidates with recovered or positive SARS-CoV-2 infection. COVID-19 severity was defined as mild in those with only upper respiratory symptoms, moderate when requiring low flow oxygen, and severe in cases with higher oxygen requirement. * = Cases which were RT-PCR positive at the time of transplant surgery. Abbreviations: ALF, acute liver failure; ACLF, acute on chronic liver failure; COVID-19, coronavirus disease; CT, cycle threshold; DD, deceased donation; F, female; HAT, hepatic artery thrombosis; LD, living donation; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HBV, hepatitis B virus; HIV, human immunodeficiency virus; IS: immunosuppression; M, male; m, months; MMF, mycophenolate; NASH, non-alcoholic steatohepatitis; nRT-PCR, real-time polymerase chain test through nasopharyngeal specimen; PVT, portal venous thrombosis
| Authors | n | Type | Age/sex | Cause of liver disease | COVID-19 severity | Negative nRT-PCR prior to transplant | Waiting time after negative RT-PCR | IgG antibody test Pre-Transplant |
Donor’s COVID-19 status | IS regimen | Outcome | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Martini et al., July 2020 [71] |
1 | DD | 39/F | Autoimmune cirrhosis | Mild | 1 | 2 d after first negative and 9 d after diagnosis of COVID-19 | Not done | Negative | No change | Uneventful | 9 d |
|
Tabrizian P et al., Nov 2020 [40] |
1 | DD | 57/F | HCV, HIV, HCC | Mild | 2 | 2 mos | Positive | Negative | No change | Uneventful | 5 mos |
|
Goss MB et al., Nov 2020 [41] |
1 | DD | 4 yr/M | Hepatoblastoma | 4 | 4 wks. after resolution of symptoms | Positive | Negative | No change | Early neutropenia which recovered | 6 wks | |
|
Raut V et al., Feb 2021 [38] |
1 | DD | 36/M | Alcoholic cirrhosis | Moderate | 4 | 6 wks. of recovery | Not reported | Negative | No change | None | 10 d |
|
Rouphael et al., March 2021* [44] |
1 | DD | 27/F | Acetaminophen overdose | Mild | Positive | COVID-19 illness started 2 mos. earlier | Not reported | Negative | No change | Uneventful | 27 d |
|
Durazo FA, March 2021 [48] |
1 | DD | 47/M | Post-COVID-19 cholangiopathy | Severe | Negative | Not known | Negative | No change | Uneventful | 7 mos | |
|
Gambato et al., April 2021 [45] |
1 | DD | 63/F | Ethanol CLD | Mild | 1 | 45 d from COVID-19; 16 d from –ve report | Negative | Negative | No change | PVT | 6 mos |
|
Raj A et al., April 2021 [46] |
1 | LD | 51/M | Ethanol CLD | Mild | 2 negative | 23 d from recovery | Not reported | Negative | Lowered dose of maintenance drugs | HAT; 14 and 18 post-op d |
Graft loss; Re-transplant at 70 d Death at 80 d |
|
Dhand et al., April 2021 [37] |
1 | DD | 42/M | Alcoholic | Mild | 1 | 71 d from COVID-19; 24 d from negative | Done (negative) | Negative | No induction/no MMF | Acute rejection responded | 25 d |
|
Niess et al., April 2021 [47] |
1 | DD | 56/M | HBV cryptogenic | Mild | 2 (31 d after illness) | 15 d after negative; and 45 d after illness | Done (positive) | Negative | Tac level kept low, rest no change | Viral loads retested positive post-transplant | 70 d |
|
Natori et al., May 2021 [36••] |
14 |
DD:15 LD:1 |
Median:52.3 yr Sex: M:11 F:3 |
Not reported | 4 patients had RT-PCR positive at transplant but were IgG positive | Negative PCR not a criterion (4 out of 14 were RT-PCR positive at transplant) | Median: 147 (range 61–202) d | Done in all (4 had IgG positive with PCR positive) | Negative | No change |
• 13 good outcomes • 1 rejection • 1 death (86 d due to fungal infection) |
79 (22–190) d |
|
Kulkarni A V et al., June 2021 [35••] |
6 | LD |
Median:35.8 Sex: M:5 F:1 |
• ACLF (n = 3) • Alcohol cirrhosis (n = 2) • NASH (n = 1) |
• Mild (n = 5) • Moderate (n = 1) |
2; Last test was done 24 h before transplant |
• 4 patients after 2 wks • 2 patients after 4 wks |
1 | Negative | No change |
• 5 did well • 1 had TCR at POD 42 • 1 died sepsis at POD 24 |
~ 1 mo |
|
Manzia et al., July 2021* [42] |
1 | DD | 35/F | HBV |
Asymptomatic; X-ray showing ground glass opacities |
RT-PCR + ve | Positive RT-PCR | Positive | Positive | No change | Uneventful | 2 mos |
|
Faruqui S. et al., July 2021 [49] |
1 | LD | Post-COVID-19 cholangiopathy | Severe | Negative | No change | Uneventful | |||||
|
Gonzalez A et al., July 2021 [39] |
1 | DD | 46/F | Alcoholic cirrhosis | Mild | 2 | 2 wks., 30 d from symptom onset | Not done | Negative | No change | Uneventful | 140 d |
|
Yohanathan L et al., Aug 2021* [43] |
1 | DD | 18/F | ALF Wilson’s disease | Critical; intubated | Positive with low CT values | 17 d from the onset of COVID-19 symptom | Negative | Negative | MMF not started initially | Uneventful | 37 d |