Liver transplantation from deceased donors with Coronavirus-disease ۲۰۱۹

Background and Aim : The transplant patients should be considered a main high-risk population during the COVID-۱۹ outbreak . However, the rejection of all (SARS-CoV-۲) positive donors leads to the loss of remarkable numbers of transplantable organs, which can save the lives of many patients. Since there is no enough evidence on COVID-۱۹ transmission through organ transplantation, this study aimed to evaluate the possibility of COVID-۱۹ transmission by liver transplantation from a donor with a late complication of COVID-۱۹ to the recipients. Methods : This descriptive study was conducted on all the recipients of liver transplantation who had an acute liver failure or were the models for the End-Stage Liver Disease (MELD) higher than ۲۰. From March ۲۰۲۰ to March ۲۰۲۱.Results : ۱۵۳ brain deaths were reported in our center due to trauma (n=۴۳), anoxia (n=۴۱), and brain tumor (n=۸); however, ۱۴ candidates were excluded due to respiratory failure. Furthermore, hemorrhagic strokes were diagnosed in ۶۱ cases. It is worth mentioning that lung involvement compatible with the late phase of COVID-۱۹ was observed in all of these cases. In general, ۳۶ liver transplantation was performed during the study period. Out of these patients, only ۱۴ cases (deceased donors) had hemorrhagic cerebrovascular accidents, and other donors died of trauma (n=۷) and anoxia (n=۱۵). All patients showed negative results for polymerase chain reaction (PCR) (two negative ۲۴ h PCR), whereas their high-resolution computed tomography (HRCT) test revealed that they had previously lung involvement with COVID-۱۹ as the late complication of the disease. All recipients (n=۱۴) had normal chest CT scans and negative COVID-۱۹ PCR ۴۸ h before transplantation, while after transplantation, three patients (۲۱.۴%) showed positive PCR in the early phase (one week after transplantation) and had lung involvement.Conclusion : This study supports the safety of continuing donation and transplant process during the outbreak even the transplant donor be infected previously with the COVID-۱۹, which is reinforced by other similar pieces of evidence

کلیدواژه ها:

Brain death ، COVID-۱۹ ، Donors ، Liver transplantation