Successful liver transplantation in a patient recovered from COVID-19
Successful liver transplantation in a patient recovered from COVID-19
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DOI：
10.1111/tid.13492
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发表时间：
2020-10-22
影响因子：
2.6
通讯作者：
Nishida, Seigo
中科院分区：
文献类型：
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作者：
Dhand, Abhay;Bodin, Roxana;Nishida, Seigo
对最近从COVID-19中康复的潜在候选人进行移植是一项挑战，涉及诊断、多器官系统受累、免疫功能低下患者的病毒脱落延长和最佳免疫抑制等方面的不确定性。一名42岁男性酒精性肝炎患者在首次诊断COVID-19后71天接受了成功的死亡供体肝移植。在移植时，他是SARS-CoV-2 PCR阴性24天，MELD评分为33。他的手术后过程是复杂的急性排斥反应，反应强烈的免疫抑制使用T细胞耗竭和类固醇。他出院时终末器官功能正常，没有任何活动性感染（包括COVID-19）的证据。在经过仔细的移植前评估、供体选择和个体化风险效益分析后，已从COVID-19中康复的潜在器官移植受者可以考虑移植。
Transplantation in potential candidates who have recently recovered from COVID-19 is a challenge with uncertainties regarding the diagnosis, multi-organ systemic involvement, prolonged viral shedding in immunocompromised patients, and optimal immunosuppression. A 42 year male with alcoholic hepatitis underwent a successful deceased donor liver transplantation 71 days after the initial diagnosis of COVID-19. At the time of transplant, he was SARS-CoV-2 PCR negative for 24 days and had a MELD score of 33. His post-operative course was complicated by acute rejection which responded to intense immune-suppression using T-cell depletion and steroids. He was discharged with normal end-organ function and no evidence of any active infection including COVID-19. Prospective organ transplant recipients who have recovered from COVID-19 can be considered for transplantation after careful pre-transplant evaluation, donor selection, and individualized risk-benefit analysis.