Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre
Background Liver transplantation is a proven management method for end-stage cirrhosis and is estimated to have increased life expectancy by 15 years. The COVID-19 pandemic posed a challenge to patients who were candid for a solid-organ transplant. It has been suggested that the outcomes of liver tr...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/10/1/e001084.full |
| _version_ | 1827184206009073664 |
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| author | Alimohammad Moradi Alireza Hadizadeh Fereshte Ghiasvand Zahra Ahmadinejad Mohsen Nasiri Toosi Samrand Ghazi Ali Jafarian Mohsen Ahmadi-Tafti Aryan Ayati |
| author_facet | Alimohammad Moradi Alireza Hadizadeh Fereshte Ghiasvand Zahra Ahmadinejad Mohsen Nasiri Toosi Samrand Ghazi Ali Jafarian Mohsen Ahmadi-Tafti Aryan Ayati |
| author_sort | Alimohammad Moradi |
| collection | DOAJ |
| description | Background Liver transplantation is a proven management method for end-stage cirrhosis and is estimated to have increased life expectancy by 15 years. The COVID-19 pandemic posed a challenge to patients who were candid for a solid-organ transplant. It has been suggested that the outcomes of liver transplants could be adversely affected by the infection, as immunosuppression makes liver transplant candidates more susceptible to adverse effects while predisposing them to higher thrombotic events.Material and methods In this retrospective study, the cases who received liver transplants from January 2018 to March 2022 were assessed regarding early postoperative mortality rate and hepatic artery thrombosis (HAT) with COVID-19 infection. This study included 614 cases, of which 48 patients were infected.Results This study shows that the early COVID-19-related early postoperative mortality rates substantially increased in the elective setting (OR: 2.697), but the results for the acute liver failure were insignificant. The average model for end-stage liver disease score increased significantly during the pandemic due to new regulations. Although mortality rates increased during the pandemic, the data for the vaccination period show that mortality rates have equalised with the prepandemic era. Meanwhile, COVID-19 infection is assumed to have increased HAT by 1.6 times in the elective setting.Conclusion This study shows that COVID-19 infection in an acute liver failure poses comparatively little risk; hence transplantation should be considered in such cases. Meanwhile, the hypercoagulative state induced by the infection predisposes this group of patients to higher HAT rates. |
| first_indexed | 2024-03-08T18:22:32Z |
| format | Article |
| id | doaj.art-ade909656d804a3187d6c7412e6fa2af |
| institution | Directory Open Access Journal |
| issn | 2054-4774 |
| language | English |
| last_indexed | 2025-03-21T06:30:48Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj.art-ade909656d804a3187d6c7412e6fa2af2024-07-21T04:05:09ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742023-11-0110110.1136/bmjgast-2022-001084Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centreAlimohammad Moradi0Alireza Hadizadeh1Fereshte Ghiasvand2Zahra Ahmadinejad3Mohsen Nasiri Toosi4Samrand Ghazi5Ali Jafarian6Mohsen Ahmadi-Tafti7Aryan Ayati8Liver transplant research center, Tehran University of Medical Sciences, tehran, IranResearch Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Research Institute, Tehran University of Medical Sciences, tehran, IranTropical and Infectious Diseases, Tehran University of Medical Sciences, tehran, IranTropical and Infectious Diseases, Tehran University of Medical Sciences, tehran, IranInternal Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)Anesthesia and Critical Care, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)Liver transplant research center, Tehran University of Medical Sciences, tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, tehran, IranResearch Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Research Institute, Tehran University of Medical Sciences, tehran, IranBackground Liver transplantation is a proven management method for end-stage cirrhosis and is estimated to have increased life expectancy by 15 years. The COVID-19 pandemic posed a challenge to patients who were candid for a solid-organ transplant. It has been suggested that the outcomes of liver transplants could be adversely affected by the infection, as immunosuppression makes liver transplant candidates more susceptible to adverse effects while predisposing them to higher thrombotic events.Material and methods In this retrospective study, the cases who received liver transplants from January 2018 to March 2022 were assessed regarding early postoperative mortality rate and hepatic artery thrombosis (HAT) with COVID-19 infection. This study included 614 cases, of which 48 patients were infected.Results This study shows that the early COVID-19-related early postoperative mortality rates substantially increased in the elective setting (OR: 2.697), but the results for the acute liver failure were insignificant. The average model for end-stage liver disease score increased significantly during the pandemic due to new regulations. Although mortality rates increased during the pandemic, the data for the vaccination period show that mortality rates have equalised with the prepandemic era. Meanwhile, COVID-19 infection is assumed to have increased HAT by 1.6 times in the elective setting.Conclusion This study shows that COVID-19 infection in an acute liver failure poses comparatively little risk; hence transplantation should be considered in such cases. Meanwhile, the hypercoagulative state induced by the infection predisposes this group of patients to higher HAT rates.https://bmjopengastro.bmj.com/content/10/1/e001084.full |
| spellingShingle | Alimohammad Moradi Alireza Hadizadeh Fereshte Ghiasvand Zahra Ahmadinejad Mohsen Nasiri Toosi Samrand Ghazi Ali Jafarian Mohsen Ahmadi-Tafti Aryan Ayati Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre BMJ Open Gastroenterology |
| title | Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre |
| title_full | Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre |
| title_fullStr | Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre |
| title_full_unstemmed | Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre |
| title_short | Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre |
| title_sort | does covid 19 infection significantly affect liver transplantation results of liver transplantation in the covid 19 era at a single high volume centre |
| url | https://bmjopengastro.bmj.com/content/10/1/e001084.full |
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