Shifting perspectives in liver diseases after kidney transplantation

Table 1 Hepatic contraindications and risk of drug-induced liver injury among SARS-CoV-2 treatment drugs

Drug	Liver Contraindication	Risk of DILI
Systemic corticosteroids	Caution in liver failure	+
Remdesivir	ALT > 5 × ULN	++
Tocilizumab	ALT > 5 × ULN	++
Sarilumab	ALT > 1.5 × ULN	++
Anakinra	Efficacy and safety in patients with AST/ALT ≥ 1.5 × ULN not been evaluated.	+
	Not recommended with severe hepatic impairment (Child-Pugh C)
Baricitinib	Not recommended with severe hepatic impairment (Child-Pugh C)	+
Tofacitinib	Not recommended with severe hepatic impairment (Child-Pugh C)	+
Nirmatrelvir/ritonavir	Not recommended with severe hepatic impairment (Child-Pugh C)	+
Lopinavir/ritonavir	Not recommended with severe hepatic impairment (Child-Pugh C)	++
Molnupiravir	Limited experience of the use with any degree of hepatic impairment.	+
Casirivimab/imdevimab	Not recommended with severe hepatic impairment (Child-Pugh C)	+
Sotrovimab	No data in patients with ALT 5 to < 10 × ULN).	+
Tixagevimab/cilgavimab	Not been evaluated in patients with hepatic impairment	+
Regdanvimab	Not been evaluated in patients with hepatic impairment	+

ALT: Alanine transaminase; AST: Aspartate aminotransferase; ULN: Upper limit normal; +: Uncommon; ++: Common; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.