A case of an Infant with SARS-CoV-2 hepatitis early after liver transplantation
A case of an Infant with SARS-CoV-2 hepatitis early after liver transplantation
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DOI：
10.1111/petr.13778
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发表时间：
2020-06-25
影响因子：
1.3
通讯作者：
Martinez, Mercedes
中科院分区：
文献类型：
--
作者：
Heinz, Nicole;Griesemer, Adam;Martinez, Mercedes
我们报告一例小儿肝移植受者在接受其母亲活体肝移植后4天被诊断为严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染。受体是一个6个月大的晚期肝病由于胆道闭锁和失败的加塞。该婴儿植入无并发症，移植物功能良好，肝酶呈下降趋势，直至出现发热、腹泻和中度呼吸窘迫，需要无创呼吸支持。术后第4天（POD）SARS-CoV-2检测（鼻拭子聚合酶链反应）呈阳性。在POD 6，肝酶达到类似于1000 U/L的峰值（比前一天高5倍）。组织学检查显示中度急性肝炎和轻度至中度急性细胞排斥反应的典型要素的混合图片。她的肝炎和呼吸道症状改善与完成羟氯喹治疗、减少免疫抑制和静脉注射丙种球蛋白（IVIG）一致。
We present a case of a pediatric liver transplant recipient diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection four days after receiving a living donor liver allograft from her mother. The recipient was a 6-month-old with end-stage liver disease due to biliary atresia and failed Kasai. The infant had an uncomplicated implantation, excellent graft function and down-trending liver enzymes until developing fevers, diarrhea, and moderate respiratory distress requiring non-invasive respiratory support. SARS-CoV-2 testing (nasal swab Polymerase Chain Reaction) was positive on post-operative day (POD) 4. Liver enzymes peaked similar to 1000 U/L (5-fold higher than the previous day) on POD 6. Histology demonstrated a mixed picture of moderate acute hepatitis and classical elements of mild to moderate acute cellular rejection. Her hepatitis and respiratory symptoms improved coincident with completing treatment with hydroxychloroquine, reduced immunosuppression, and intravenous gamma globulin (IVIG).