The impact of the COVID-19 outbreak on liver transplantation programs in Northern Italy: American Journal of Transplantation

U. Maggi, L. De Carlis, D. Yiu, M. Colledan, E. Regalia, G. Rossi, M. Angrisani, D. Consonni, G. Fornoni, G. Piccolo, T.M. DeFeo

Research output: Contribution to journalArticlepeer-review

Abstract

In January 2020, Novel Coronavirus Disease 2019 (COVID-19) resulted in a global pandemic, creating uncertainty toward the management of liver transplantation (LT) programs. Lombardy has been the most affected region in Italy: the current mortality rate of COVID-19 patients is 18.3% (10 022 deaths; April 10th) with hospitals in Lombardy having to expand the total number of ICU beds from 724 to 1381 to accommodate infected patients. There has been a drastic decrease in liver donors. From February 23rd until April 10th, 17 LTs were performed in Lombardy. Mean donor age was 49 years (range 18-74) whereas mean recipient age was 55 (13-69); mean MELD score was 12 (6-24). All donors underwent screening for SARS-CoV-2 prior to LT. Two patients tested positive after LT, and one patient died for COVID on POD 30. Sixteen patients are alive after an average of 30 days post-LT (range 3-46). 10 patients have been discharged. This study has found no specific reason concerning the safety of recipients, to stop LT programs. Several key lessons from our experience are reported. However, due to the complex circumstances which surround the viral outbreak, the cessation or a reduction in LT activity is a pragmatic requirement.

Original languageEnglish
Pages (from-to)1840-1848
Number of pages9
JournalAm. J. Transplant.
Volume20
Issue number7
DOIs
Publication statusPublished - Jul 1 2020

Keywords

  • bronchoalveolar lavage (BAL)
  • clinical research/practice
  • critical care/intensive care management
  • epidemiology
  • infection and infectious agents – viral
  • liver transplantation/hepatology
  • organ allocation
  • basiliximab
  • prednisolone
  • tacrolimus
  • adult
  • aged
  • Article
  • coronavirus disease 2019
  • female
  • fever
  • follow up
  • graft recipient
  • human
  • Italy
  • liver donor
  • liver transplantation
  • major clinical study
  • male
  • Model For End Stage Liver Disease Score
  • mortality rate
  • postoperative complication
  • priority journal
  • screening
  • Severe acute respiratory syndrome coronavirus 2
  • adolescent
  • Betacoronavirus
  • complication
  • Coronavirus infection
  • donor
  • end stage liver disease
  • laboratory technique
  • middle aged
  • pandemic
  • prognosis
  • transplantation
  • treatment outcome
  • virus pneumonia
  • young adult
  • Adolescent
  • Adult
  • Aged
  • Clinical Laboratory Techniques
  • Coronavirus Infections
  • End Stage Liver Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Transplantation
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral
  • Prognosis
  • Tissue and Organ Procurement
  • Tissue Donors
  • Treatment Outcome
  • Young Adult

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