|
1
|
Bhasin S, Byrne M, Alpizar-Rivas R, Chavez-Villa M, Ruffolo L, Cisneros R, Prasad P, Pineda-Solis K. Transplantation in the Pandemic Era: Perspectives on the Utilization of COVID-19 Positive Organs. Transplant Proc 2024; 56:1536-1542. [PMID: 39060138 DOI: 10.1016/j.transproceed.2024.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/25/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND At early stages of the pandemic, most organ procurements organizations considered COVID-19 infected donors to be ineligible for organ donation. The aim of this survey is to describe the current practices of the utilization of COVID-19 positive organs donors among American Society of Transplant Surgeons (ASTS) members. METHODS An anonymous 40-question redcap survey was emailed to ASTS members from June to August 2022. RESULTS One hundred forty-nine surveys from 10 countries were included for analysis. The majority of the responders were men (66.7%) from North America (95%) and identified as transplant surgeons (68.5%). Most work at academic institutions (76.5%). Almost all responders (94%) were willing to accept an organ from a donor with a history of COVID-19 who tested negative at the time of donation, however, there was no consensus on the length of time after the disease was resolved. Approximately 70% indicated they accept organs from asymptomatic donors with active disease. Only 32 responders indicated they would accept an organ from an individual with a history of "severe" COVID-19 infection and less than one third of the responders would accept an organ from a donor who died from COVID-19 infection. Interestingly, 80% indicated they have protocols at their institution to guide the acceptance of such organs. DISCUSSION Despite new evidence that the transmission of COVID-19 in non-lung organs is extremely rare, the results of this survey suggest significant heterogeneity in practice and perceptions of the use of COVID-19 positive organs across international centers. We suggest that the implementation of a standardized protocol is of paramount importance to continue safe transplant activity.
Collapse
Affiliation(s)
- Shreya Bhasin
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Matthew Byrne
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Rodolfo Alpizar-Rivas
- Department of Infectious Disease, University of Rochester Medical Center, Rochester, New York
| | - Mariana Chavez-Villa
- Department of Transplant Surgery, University of Rochester Medical Center, Rochester, New York
| | - Luis Ruffolo
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Rafael Cisneros
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Paritosh Prasad
- Department of Infectious Disease, University of Rochester Medical Center, Rochester, New York
| | - Karen Pineda-Solis
- Department of Transplant Surgery, University of Rochester Medical Center, Rochester, New York.
| |
Collapse
|
|
2
|
Dettori M, Riccardi N, Canetti D, Antonello RM, Piana AF, Palmieri A, Castiglia P, Azara AA, Masia MD, Porcu A, Ginesu GC, Cossu ML, Conti M, Pirina P, Fois A, Maida I, Madeddu G, Babudieri S, Saderi L, Sotgiu G. Infections in lung transplanted patients: A review. Pulmonology 2024; 30:287-304. [PMID: 35710714 DOI: 10.1016/j.pulmoe.2022.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/29/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Lung transplantation can improve the survival of patients with severe chronic pulmonary disorders. However, the short- and long-term risk of infections can increase morbidity and mortality rates. A non-systematic review was performed to provide the most updated information on pathogen, host, and environment-related factors associated with the occurrence of bacterial, fungal, and viral infections as well as the most appropriate therapeutic options. Bacterial infections account for about 50% of all infectious diseases in lung transplanted patients, while viruses represent the second cause of infection accounting for one third of all infections. Almost 10% of patients develop invasive fungal infections during the first year after lung transplant. Pre-transplantation comorbidities, disruption of physical barriers during the surgery, and exposure to nosocomial pathogens during the hospital stay are directly associated with the occurrence of life-threatening infections. Empiric antimicrobial treatment after the assessment of individual risk factors, local epidemiology of drug-resistant pathogens and possible drug-drug interactions can improve the clinical outcomes.
Collapse
Affiliation(s)
- M Dettori
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - N Riccardi
- StopTB Italia Onlus, Milan, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - D Canetti
- StopTB Italia Onlus, Milan, Italy; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R M Antonello
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
| | - A F Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Palmieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A A Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M D Masia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G C Ginesu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M L Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M Conti
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - P Pirina
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - A Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - I Maida
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Madeddu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - S Babudieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - L Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; StopTB Italia Onlus, Milan, Italy.
| |
Collapse
|
|
3
|
Mezochow AK, Anesi J, West S, Hasz R, Edwards J, Blumberg EA. COVID-19 in organ donors: An organ procurement organization perspective. Transpl Infect Dis 2024; 26:e14230. [PMID: 38191801 DOI: 10.1111/tid.14230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND The COVID-19 pandemic presented a significant challenge for Organ Procurement Organizations (OPOs) with the use of SARS-CoV-2 positive donors varying widely. This study used detailed single OPO data to determine the success of using SARS-CoV-2 positive donors. METHODS We performed a retrospective cohort study including all SARS-CoV-2 positive donors referred to the Gift of Life OPO from January 1, 2021, to June 30, 2023. Descriptive analyses were performed to characterize referral and organ utilization. RESULTS There were 861 organ referrals with 1 positive SARS-Cov-2 test: 282 were ruled out with telephone evaluation, 431 referrals were ruled out with onsite evaluation ("evaluated nondonors") and 148 became donors. For donors who had both nasopharyngeal and lower respiratory testing completed, there was notable result discordance observed. Median cycle threshold (Ct) values were similar between donors and evaluated nondonors with no change in median donor Ct values over the study period. Transplanted organs from COVID-positive donors included 27 hearts, 88 livers, 5 pancreata, and 107 kidneys; no lung donation occurred. The proportion of COVID-positive donors significantly increased over the study period. CONCLUSION This large volume donor referral study demonstrates increasing COVID-19 referrals progressing to donation over time, supporting the increased use of these donors for nonlung transplantation.
Collapse
Affiliation(s)
- Alyssa K Mezochow
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith Anesi
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sharon West
- Gift of Life Donor Program, Philadelphia, Pennsylvania, USA
| | - Richard Hasz
- Gift of Life Donor Program, Philadelphia, Pennsylvania, USA
| | - John Edwards
- Gift of Life Donor Program, Philadelphia, Pennsylvania, USA
| | - Emily A Blumberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
|
4
|
D’Avila H, Lima CNR, Rampinelli PG, Mateus LCO, de Sousa Silva RV, Correa JR, de Almeida PE. Lipid Metabolism Modulation during SARS-CoV-2 Infection: A Spotlight on Extracellular Vesicles and Therapeutic Prospects. Int J Mol Sci 2024; 25:640. [PMID: 38203811 PMCID: PMC10778989 DOI: 10.3390/ijms25010640] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
Extracellular vesicles (EVs) have a significant impact on the pathophysiological processes associated with various diseases such as tumors, inflammation, and infection. They exhibit molecular, biochemical, and entry control characteristics similar to viral infections. Viruses, on the other hand, depend on host metabolic machineries to fulfill their biosynthetic requirements. Due to potential advantages such as biocompatibility, biodegradation, and efficient immune activation, EVs have emerged as potential therapeutic targets against the SARS-CoV-2 infection. Studies on COVID-19 patients have shown that they frequently have dysregulated lipid profiles, which are associated with an increased risk of severe repercussions. Lipid droplets (LDs) serve as organelles with significant roles in lipid metabolism and energy homeostasis as well as having a wide range of functions in infections. The down-modulation of lipids, such as sphingolipid ceramide and eicosanoids, or of the transcriptional factors involved in lipogenesis seem to inhibit the viral multiplication, suggesting their involvement in the virus replication and pathogenesis as well as highlighting their potential as targets for drug development. Hence, this review focuses on the role of modulation of lipid metabolism and EVs in the mechanism of immune system evasion during SARS-CoV-2 infection and explores the therapeutic potential of EVs as well as application for delivering therapeutic substances to mitigate viral infections.
Collapse
Affiliation(s)
- Heloisa D’Avila
- Cell Biology Laboratory, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (H.D.); (P.G.R.); (L.C.O.M.); (R.V.d.S.S.)
| | | | - Pollianne Garbero Rampinelli
- Cell Biology Laboratory, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (H.D.); (P.G.R.); (L.C.O.M.); (R.V.d.S.S.)
| | - Laiza Camila Oliveira Mateus
- Cell Biology Laboratory, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (H.D.); (P.G.R.); (L.C.O.M.); (R.V.d.S.S.)
| | - Renata Vieira de Sousa Silva
- Cell Biology Laboratory, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (H.D.); (P.G.R.); (L.C.O.M.); (R.V.d.S.S.)
| | - José Raimundo Correa
- Laboratory of Microscopy and Microanalysis, University of Brasília, Brasília 70910-900, Brazil;
| | - Patrícia Elaine de Almeida
- Cell Biology Laboratory, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil; (H.D.); (P.G.R.); (L.C.O.M.); (R.V.d.S.S.)
| |
Collapse
|
|
5
|
Fox D, Hall M, Thibodeau C, Coldwell K, Lauder L, Dewell S, Davidson S. Impact of the COVID-19 pandemic on Canadian transplant journeys: a mixed methods study. BMJ Open 2023; 13:e068347. [PMID: 38040429 PMCID: PMC10693860 DOI: 10.1136/bmjopen-2022-068347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/20/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Navigating the organ donation and transplantation system in Canada can be challenging for individuals on transplant journeys. Although it is likely that the COVID-19 pandemic has further contributed to these challenges, the experiences of individuals during the pandemic in Canada have not been well elicited. OBJECTIVE To illuminate how the COVID-19 pandemic has impacted individuals on transplant journeys in Canada. DESIGN Convergent parallel mixed-methods study. SETTING Canada. PARTICIPANTS Adult patients, caregivers, and donors on transplant journeys across Canada. DATA COLLECTION Eight focus groups and an online survey between May and November 2021. Focus group transcripts were analysed using an inductive conventional content analysis approach. Survey data were analysed using descriptive statistics. The study was guided by individuals with lived experience of organ donation and transplantation. RESULTS A total of 830 participants completed three COVID-19 related survey questions, with 21 participating in the focus groups. Survey results: over 50% of patients and caregivers reported that the pandemic impacted their access to their healthcare team, their mental health (60% and 65%, respectively) and their comfort going out in public (80% and 75%, respectively). Although many donors reported several factors that impacted their transplant journey, the impact appeared to be greater for patients and caregivers. Qualitative results: three themes emerged from the qualitative data that contextualise participant's experiences: compounding isolation, disruption amid uncertainty and unforeseen benefits. CONCLUSION The COVID-19 pandemic has exacerbated many of the challenges that individuals on transplant journeys experience. It will be critical for transplant programmes to consider these factors in future care provision.
Collapse
Affiliation(s)
- Danielle Fox
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Marc Hall
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Kristi Coldwell
- Transplant Research Foundation of British Columbia, Vancouver, British Columbia, Canada
| | - Lydia Lauder
- Kidney Foundation of Canada, Montreal, Québec, Canada
| | - Sarah Dewell
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
|
6
|
Puerto Nino AK, Batistella Zasso F, Boonchit A, Salim S, Mirza R, Ferenbok J, Mucsi I, Boon H, Levy G. A Qualitative Study on the Effects of the COVID-19 Pandemic on Solid Organ Transplantation. Prog Transplant 2023; 33:328-334. [PMID: 37964560 PMCID: PMC10691250 DOI: 10.1177/15269248231212912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Introduction: Solid organ transplantation is a lifesaving intervention requiring extensive coordination and communication for timely and safe care. The COVID-19 pandemic posed unique challenges to the safety and management of solid organ transplantation. This descriptive qualitative study aimed to understand how hospital stakeholders were affected by and responded to the COVID-19 pandemic to contribute toward improved healthcare delivery responses and strategies during times of systemic strain on the healthcare system. Methods: One-hour-long semistructured interviews were performed in 3 cohorts: healthcare professionals (N = 6), administrative staff (N = 6), and recipients (N = 4). Interviews were analyzed using conventional thematic content analysis. Thematic saturation was reached within each cohort. Findings: Twelve codes and 6 major themes were identified including the Impact on Clinical Practice, Virtual Healthcare Delivery, Communication, Research, Education and Training, Mental Health and Future Pandemic Planning. Reflecting on these codes and major themes, 4 recommendations were developed (Anticipation and Preparation, Maximizing Existing Resources and Networks, Standardization and the Virtual Environment and Caring for the Staff) to guide transplant programs to optimize healthcare pathways while enhancing the best practices during future pandemics. Conclusion: Transplant programs will benefit from anticipation and preparation procedures using ramping-down strategies, resource planning, and interprofessional collaboration while maximizing existing resources and networks. In parallel, transplant programs should standardize virtual practices and platforms for clinical and educational purposes while maintaining an open culture of mental health discussion and integrating strategies to support staff's mental health.
Collapse
Affiliation(s)
- Angie K. Puerto Nino
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Doctoral Programme in Clinical Research, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fabricio Batistella Zasso
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anaesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Atina Boonchit
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sabrin Salim
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raza Mirza
- Factor-Interwash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Ferenbok
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Istvan Mucsi
- Ajmera Transplant Center, University Health Network, Toronto, Ontario, Canada
| | - Heather Boon
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Gary Levy
- Institute of Medical Science, University of Toronto, Thornhill, Ontario, Canada
| |
Collapse
|
|
7
|
Natori Y, Anjan S, Simkins J, Abbo L, Manickavel S, Salgado J, Sinha N, Pipkins M, Pelaez A, Machuca T. Successful lung transplantation in COVID-19 PCR positive patients: A single-center experience. J Heart Lung Transplant 2023; 42:1478-1479. [PMID: 37269877 PMCID: PMC10232938 DOI: 10.1016/j.healun.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/15/2023] [Accepted: 05/30/2023] [Indexed: 06/05/2023] Open
Affiliation(s)
- Yoichiro Natori
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida.
| | - Shweta Anjan
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Jacques Simkins
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Lilian Abbo
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Suresh Manickavel
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan Salgado
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Neeraj Sinha
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Mauricio Pipkins
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Andres Pelaez
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Tiago Machuca
- Miami Transplant Institute, Jackson Health System, Miami, Florida; Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| |
Collapse
|
|
8
|
Karaaslan M, Yılmaz M, Polat ME, Şirin ME, Ölçücüoğlu E, Ölçücüoğlu E. The Impact of COVID-19 on Renal Resistive Index in Kidney Transplant Recipients. Transplant Proc 2023; 55:1862-1865. [PMID: 37127517 PMCID: PMC10076514 DOI: 10.1016/j.transproceed.2023.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND There is a lack of renal resistive index (RRI)-based data on the effects of COVID-19 in transplant patients. We aimed to investigate the effect of COVID-19 on the RRI of renal transplant recipients and to review the outcomes of patients who underwent renal transplantation (RT) before and during the COVID-19 pandemic. METHODS The data of 90 recipients were retrospectively reviewed. The age, sex, body mass index, dialysis time before transplantation, history of COVID-19, postoperative serum creatinine levels (1, 6, and 12 months), and complications of the recipients were recorded. The before and after COVID-19 RRI values of 13 recipients at 1 week after transplant and 3 months after COVID-19 were compared. The outcomes and complications of recipients who underwent RT before the COVID-19 pandemic (group 1, n = 47) and during the COVID-19 pandemic (group 2, n = 43) were also compared. RESULTS There was a statistically significant difference in terms of the median RRI values of 13 recipients before and after COVID-19 (0.6 [0.53-0.76] vs 0.7 [0.62-0.9], respectively [P = .032]). At the 12-month follow-up, the serum creatinine and estimated glomerular filtration rate levels were found to be statistically significantly higher in group 1 than in group 2 (P = .001 and P = .004, respectively). There was no statistically significant difference between group 1 and group 2 regarding complication rates (53.2% vs 60.5%, respectively; P > .05). CONCLUSIONS We found that COVID-19 affected RRI values in RT recipients. Our findings show that the outcomes of kidney transplants performed during the COVID-19 pandemic were no worse than those of transplants performed before the pandemic.
Collapse
Affiliation(s)
| | - Mehmet Yılmaz
- Urology, Asklepios Klinik Triberg, Triberg, Germany.
| | - Muhammed Emin Polat
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Emin Şirin
- Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Esin Ölçücüoğlu
- Department of Radiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erkan Ölçücüoğlu
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
|
9
|
Li L, Zhang Y, Xiao F, Qu W, Zhang H, Zhu Z. Liver retransplantation: Timing is equally important. Medicine (Baltimore) 2023; 102:e35165. [PMID: 37713841 PMCID: PMC10508473 DOI: 10.1097/md.0000000000035165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 08/21/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND AND AIM To evaluate the effect of transplantation interval on patient and graft survival in liver retransplantation (reLT) using meta-analytical techniques. METHODS Literature search was undertaken until January 2022 to identify comparative studies evaluating patient survival rates, graft survival rates, and the interval time. Pooled hazard ratio (HR) or risk ratio (RR) and 95% confidence intervals (95% CI) were calculated with either the fixed or random effect model. RESULTS The 12 articles were included in this meta-analysis. The late reLT survival rate is better than the early reLT in the 30 days group, and there is no statistical significance in other time groups. The patient survival was significantly higher in late reLT than early reLT at 1 and 5 years (respectively: RR, 0.81 [95% CI, 0.73-0.89]; RR, 0.64 [95% CI, 0.46-0.88]). The graft survival was significantly higher in late reLT than early reLT at 1 year (RR, 0.75 [95% CI, 0.63-0.89]). The risk of death after reLT in early group was 1.43 times higher than that in late group (HR, 1.43 [95% CI, 1.21-1.71]). CONCLUSIONS Late reLT had significantly better survival rates than early reLT, and the transplantation interval was more reasonable to divide the early or late groups by 30 days.
Collapse
Affiliation(s)
- Le Li
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Hepatobiliary Surgery, Chifeng Municipal Hospital, Chifeng, China
| | - Yuhong Zhang
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fei Xiao
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Qu
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haiming Zhang
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhijun Zhu
- Liver Transplantation Center, Clinical Research Center for Pediatric Liver Transplantation, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
|
10
|
Sever MS, Vanholder R, Oniscu G, Abramowicz D, Van Biesen W, Maggiore U, Watschinger B, Mariat C, Buturovic-Ponikvar J, Crespo M, Mjoen G, Heering P, Peruzzi L, Gandolfini I, Hellemans R, Hilbrands L. Kidney transplantation during mass disasters - from COVID-19 to other catastrophes A Consensus Statement by the DESCARTES Working Group and Ethics Committee of the ERA. Nephrol Dial Transplant 2023; 38:300–308. [PMID: 36066915 PMCID: PMC9923698 DOI: 10.1093/ndt/gfac251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Indexed: 07/23/2023] Open
Abstract
Mass disasters are characterized by a disparity between health care demand and supply, which hampers complex therapies like kidney transplantation. Considering scarcity of publications on previous disasters, we reviewed transplantation practice during the recent COVID-19 pandemic, and dwelled upon this experience for guiding transplantation strategies in the future pandemic and non-pandemic catastrophes. We strongly suggest continuing transplantation programs during mass disasters, if medical and logistic operational circumstances are appropriate. Postponing transplantations from living donors and referral of urgent cases to safe regions or hospitals are justified. Specific preventative measures in anticipated disasters (such as vaccination programs during pandemics or evacuation in case of hurricanes or wars) may be useful to minimize risks. Immunosuppressive therapies should consider stratifying risk status and avoiding heavy immune suppression in patients with a low probability of therapeutic success. Discharging patients at the earliest convenience is justified during pandemics, whereas delaying discharge is reasonable in other disasters, if infrastructural damage results in unhygienic living environments for the patients. In the outpatient setting, telemedicine is a useful approach to reduce the patient load to hospitals, to minimize the risk of nosocomial transmission in pandemics and the need for transport in destructive disasters. If it comes down to save as many lives as possible, some ethical principles may vary in function of disaster circumstances, but elementary ethical rules are non-negotiable. Patient education is essential to minimize disaster-related complications and to allow for an efficient use of health care resources.
Collapse
Affiliation(s)
| | - Raymond Vanholder
- European Kidney Health Alliance, Brussels, Belgium; Department of Internal Medicine and Pediatrics, Nephrology Section, Ghent University Hospital, Ghent, Belgium
| | | | | | - Wim Van Biesen
- Department of Internal Medicine and Pediatrics, Nephrology Section, Ghent University Hospital, Ghent, Belgium
| | - Umberto Maggiore
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Bruno Watschinger
- Medical University of Vienna, Department of Medicine III, Division of Nephrology and Dialysis, Vienna, Austria
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation rénale, Centre Hospitalier Universitaire de Saint Etienne, Hôpital NORD, Université de Lyon, Université Jean Monnet, Saint Etienne, France
| | | | - Marta Crespo
- Hospital del Mar, Department of Nephrology, Barcelona, Spain
| | - Geir Mjoen
- Section of Nephrology, Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway
| | - Peter Heering
- Klinik für Nephrologie und Allgemeine Innere Medizin, Städtisches Klinikum Solingen, Solingen, Germany
| | | | | | - Rachel Hellemans
- Department of Nephrology and Hypertension, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Luuk Hilbrands
- Radboud university medical center, Department of Nephrology, Nijmegen, The Netherlands
| |
Collapse
|
|
11
|
Passoni R, Gadonski B, Carvalho ARDS, Freitas TVDS, Peres LAB. The impact of COVID-19 on kidney transplant activities in Brazil: a descriptive study. SAO PAULO MED J 2023; 141:60-66. [PMID: 36043676 PMCID: PMC9808990 DOI: 10.1590/1516-3180.2021.0956.r1.29042022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The coronavirus 19 (COVID-19) pandemic has reached services, systems, and world society. Despite its certified efficiency, the Brazilian National Transplant System is not exempt from the side effects of COVID-19. OBJECTIVE To compare kidney transplantation activity registered in Brazil between the pandemic (2020) and pre-pandemic (2019) periods. DESIGN AND SETTING A descriptive study was conducted in March 2021. The annual reports of the Brazilian Transplantation Registry for 2019 and 2020 were included in this study. METHODS We conducted a descriptive study of kidney transplant activity in Brazil in 2019 and 2020. RESULTS A 23.9% decrease in kidney transplants per million population was observed during the pandemic period (22.9 in 2020 versus 30.1 in 2019). Kidney transplants with a living donor (-58.8%) and in the North Region (-79.5%) experienced the greatest declines. The pandemic waiting list increased by 6.8%, and deaths during the waiting period increased by 36.8%. The number of patients on the waiting list and transplant teams decreased by 31.3% and 9.5%, respectively. CONCLUSION The COVID-19 pandemic drastically affected Brazil and had a significant negative impact on KT activities in the country.
Collapse
Affiliation(s)
- Reginaldo Passoni
- RN, MSc. Nurse, Department of Nursing, Hospital Universitário, Universidade Estadual do Oeste do Paraná (UNIOSTE), Cascavel (PR), Brazil
| | - Bruno Gadonski
- Medicine Student, Center for Medical and Pharmaceutical Sciences, Universidade Estadual do Oeste do Paraná (UNIOSTE), Cascavel (PR), Brazil
| | - Ariana Rodrigues da Silva Carvalho
- RN, PhD. Professor, Postgraduate Program in Biosciences and Health, Center for Biological and Health Sciences, Universidade Estadual do Oeste do Paraná (UNIOSTE), Cascavel (PR), Brazil
| | | | - Luis Alberto Batista Peres
- MD, PhD. Professor, Postgraduate Program in Biosciences and Health, Center for Biological and Health Sciences, Universidade Estadual do Oeste do Paraná (UNIOSTE), Cascavel (PR), Brazil
| |
Collapse
|
|
12
|
Bisen SS, Zeiser LB, Boyarsky B, Werbel W, Snyder J, Garonzik-Wang J, Levan ML, Segev DL, Massie AB. Transplantation Amid a Pandemic: The Fall and Rise of Kidney Transplantation in the United States. Transplant Direct 2023; 9:e1423. [PMID: 36582674 PMCID: PMC9750630 DOI: 10.1097/txd.0000000000001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/26/2022] [Indexed: 12/27/2022] Open
Abstract
Following the outbreak of coronavirus disease 2019 (COVID-19) in the United States, the number of kidney waitlist additions and living-donor and deceased-donor kidney transplants (LDKT/DDKT) decreased substantially but began recovering within a few months. Since then, there have been several additional waves of infection, most notably, the Delta and Omicron surges beginning in August and December 2021, respectively. Methods Using SRTR data, we compared observed waitlist registrations, waitlist mortality, waitlist removal due to deteriorating condition, LDKT, and DDKT over 5 distinct pandemic periods to expected events based on calculations from preepidemic data while accounting for seasonality and secular trends. Results Although the number of daily waitlist additions has been increasing since May 2020, the size of the active waitlist has consistently declined, reaching a minimum of 52 556 on February 27, 2022. The recent Omicron surge knocked LDKT from 25% below baseline (incidence rate ratio [IRR] = 0.690.750.81) during the Delta wave to 38% below baseline (IRR = 0.580.620.67). DDKT, however, was less affected by the Omicron wave (IRR = 0.850.890.93 and 0.880.920.96 during the Delta and Omicron waves, respectively). Waitlist death decreased from 56% above baseline (IRR = 1.431.561.70) during Delta to 41% above baseline during Omicron, whereas waitlist removal due to deteriorating condition remained at baseline/expected levels during the Delta wave (IRR = 0.931.021.12) and the Omicron wave (IRR = 0.991.071.16). Conclusions Despite exceptionally high COVID-19 incidence during the Omicron wave, the transplant system responded similarly to prior waves that imposed a lesser disease burden, demonstrating the transplant system's growing adaptations and resilience to this now endemic disease.
Collapse
Affiliation(s)
- Shivani S Bisen
- Department of Surgery, Quantitative Core, Center for Surgical and Transplant Applied Research (C-STAR), Grossman School of Medicine, New York University, New York, NY
| | - Laura B Zeiser
- Department of Surgery, Quantitative Core, Center for Surgical and Transplant Applied Research (C-STAR), Grossman School of Medicine, New York University, New York, NY
| | - Brian Boyarsky
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - William Werbel
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jon Snyder
- Scientific Registry of Transplant Recipients, Minneapolis, MN
| | | | - Macey L Levan
- Department of Surgery, Quantitative Core, Center for Surgical and Transplant Applied Research (C-STAR), Grossman School of Medicine, New York University, New York, NY
| | - Dorry L Segev
- Department of Surgery, Quantitative Core, Center for Surgical and Transplant Applied Research (C-STAR), Grossman School of Medicine, New York University, New York, NY
- Scientific Registry of Transplant Recipients, Minneapolis, MN
| | - Allan B Massie
- Department of Surgery, Quantitative Core, Center for Surgical and Transplant Applied Research (C-STAR), Grossman School of Medicine, New York University, New York, NY
| |
Collapse
|
|
13
|
Elghannam MT, Hassanien MH, Ameen YA, ELattar GM, ELRay AA, Turky EA, ELTalkawy MD. COVID-19 and liver diseases. EGYPTIAN LIVER JOURNAL 2022; 12:43. [PMID: 35880136 PMCID: PMC9301896 DOI: 10.1186/s43066-022-00202-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus causes an outbreak of viral pneumonia that spread throughout the world. Liver injury is becoming more widely recognized as a component of the clinical picture of COVID-19 infection. Hepatitis with serum ALT elevation has been reported in up to half of patients. Patients with CLD were at a higher risk of decompensation with liver failure, hospitalization, and mortality. The percentage of acute liver injury (ALI) varied from 5 to 28%. COVID-19 hinders HCV elimination by 2030. It is recommended to continue treatment of chronic HCV and chronic HBV if already receiving treatment. Consider using antiviral therapy to prevent viral flare-ups in patients with occult or resolved HBV and COVID-19 who are receiving immunosuppressive agents. Patients with AIH do not have an increased risk of adverse outcomes even in high-risk areas. There is an association between MAFLD and disease progression. Patients with any type of cancer are at a higher risk of infection and are more likely to develop more severe clinical outcomes. Most societies advise against immunosuppressant modifications in patients with mild COVID-19, whereas in rare cases such as severe lymphopenia, worsening pneumonia, or bacterial or fungal superinfection, reduction or discontinuation of antiproliferative agents and lymphocyte-depleting therapies has been suggested.
Collapse
|
|
14
|
Peled Y, Kittleson MM. Transplanting COVID-19 positive donors: Expanding our experience to widen the donor pool. J Heart Lung Transplant 2022; 41:1382-1384. [PMID: 35961830 PMCID: PMC9288352 DOI: 10.1016/j.healun.2022.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 01/31/2023] Open
Affiliation(s)
- Yael Peled
- Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, and Tel Aviv University, Tel Aviv, Israel,Reprint requests: Yael Peled, MD, Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, and Faculty of Medicine, Tel Aviv University, Israel. Telephone: 972-353-02710. Fax: 972-353-02410
| | - Michelle M. Kittleson
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California
| |
Collapse
|
|
15
|
Peghin M, Grossi PA. COVID-19 positive donor for solid organ transplantation. J Hepatol 2022; 77:1198-1204. [PMID: 35798131 PMCID: PMC9251900 DOI: 10.1016/j.jhep.2022.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/01/2022] [Accepted: 06/16/2022] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic has significantly changed organ donation and transplantation worldwide. Since the beginning of the pandemic, the uncertainty regarding the potential route of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created tremendous pressures on transplantation communities, and international organisations have advised against using organs from deceased donors who have tested positive for SARS-CoV-2. The possibility of SARS-CoV-2 transmission through organ donation has only been reported for lung transplantation; hence, based on current experience, transplantation of non-lung organs from donors with active SARS-CoV-2 infection has been considered possible and safe, at least over short-term follow-up. As the evolving outbreak of SARS-CoV-2 continues, alongside the presence of vaccines and new treatment options, clinicians should consider transplanting organs from deceased donors with active SARS-CoV-2 infection to recipients with limited opportunities for transplantation and those with specific natural or vaccine-induced immunity. This article proffers an expert opinion on the use of organs from deceased donors with resolved or active SARS-CoV-2 infection in the absence of more definitive data and standardised acceptance patterns.
Collapse
Affiliation(s)
| | - Paolo Antonio Grossi
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.
| |
Collapse
|
|
16
|
Gholamzadeh M, Abtahi H, Safdari R. Telemedicine in lung transplant to improve patient-centered care: A systematic review. Int J Med Inform 2022; 167:104861. [PMID: 36067628 DOI: 10.1016/j.ijmedinf.2022.104861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Long-term care combined with complex follow-up processes is among the essential needs of lung transplantation. Therefore, Telemedicine-based strategies can provide an effective approach for both patients and clinicians by applying remote patient monitoring. Hence, the main objective of this study was to investigate Telemedicine and telehealth usage in lung transplantation. METHOD A systematic review was conducted in four databases using keywords. Eligible studies were all English papers that developed Telemedicine-based programs to enhance patient care in lung organ transplantation. The interventions were analyzed analysis to determine the main descriptive areas. The quality of the included articles was evaluated using Mixed Methods Appraisal Tool (MMAT) tool by two authors. RESULTS Of the 261 retrieved articles, 27 met our inclusion criteria. Of these, 22 studies were devoted to the post-transplantation phase. All articles were published from 2002 to 2021 and the trend of publications has increased in recent years. Most of the studies were conducted in the United States and Canada. All eligible studies can be categorized into five types of Telemedicine interventions, 15 (55.56%) articles devoted to Telemonitoring, four (14.81%) for Teleconsultation, four (14.81%) articles for Telerehabilitation, three (11.11%) articles for Telespirometery, and one (3.70%) article were done regarding Tele-education. CONCLUSION This integrated review provides researchers with a new understanding of Telemedicine-based care solutions. Findings show that remote patient care in lung transplantation includes various aspects, especially self-care improvement.
Collapse
Affiliation(s)
- Marsa Gholamzadeh
- Ph.D. Candidate in Medical Informatics, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Abtahi
- Pulmonary and Critical Care Department, Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Safdari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
17
|
Aquino-Matus J, Uribe M, Chavez-Tapia N. COVID-19: Current Status in Gastrointestinal, Hepatic, and Pancreatic Diseases—A Concise Review. Trop Med Infect Dis 2022; 7:tropicalmed7080187. [PMID: 36006279 PMCID: PMC9415805 DOI: 10.3390/tropicalmed7080187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. The angiotensin-converting enzyme 2 receptor and the transmembrane protease serine 2 receptor bind and activate SARS-CoV-2 and are present in high concentrations throughout the gastrointestinal tract. Most patients present with gastrointestinal symptoms and/or abnormal liver function tests, both of which have been associated with adverse outcomes. The mechanisms of liver damage are currently under investigation, but the damage is usually transient and nonsevere. Liver transplantation is the only definitive treatment for acute liver failure and end-stage liver disease, and unfortunately, because of the need for ventilators during the COVID-19 pandemic, most liver transplant programs have been suspended. Patients with gastrointestinal autoimmune diseases require close follow-up and may need modification in immunosuppression. Acute pancreatitis is a rare manifestation of COVID-19, but it must be considered in patients with abdominal pain. The gastrointestinal tract, including the liver and the pancreas, has an intimate relationship with COVID-19 that is currently under active investigation.
Collapse
|
|
18
|
Anjan S, Khatri A, Viotti JB, Cheung T, Garcia LAC, Simkins J, Loebe M, Phancao A, O'Brien CB, Sinha N, Ciancio G, Vianna RM, Andrews D, Abbo LM, Guerra G, Natori Y. Is the Omicron variant truly less virulent in solid organ transplant recipients? Transpl Infect Dis 2022; 24:e13923. [PMID: 35915957 PMCID: PMC9538470 DOI: 10.1111/tid.13923] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/04/2022] [Accepted: 06/24/2022] [Indexed: 12/24/2022]
Abstract
Solid organ transplant (SOT) recipients are at high risk for severe disease with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Emerging variants of concern have disproportionately affected this population. Data on severity and outcomes with the Omicron variant in SOT recipients are limited. Thus we conducted this single-center, retrospective cohort study of SOT recipients diagnosed with SARS-CoV-2 infection from December 18, 2021 to January 18, 2022, when prevalence of the Omicron variant was more than 80%-95% in the community. Univariate and multivariate logistic regression analysis was performed to identify risk factors for hospital admission. We identified 166 SOT patients: 112 (67.5%) kidney, 22 (13.3%) liver, 10 (6.0%) lung, seven (4.2%) heart, and 15 (9.0%) combined transplants. SARS-CoV-2 vaccine series was completed in 59 (35.5%) recipients. Ninety-nine (59.6%) and 13 (7.8%) recipients received casirivimab/imdevimab and sotrovimab, respectively. Fifty-three (32%) recipients required hospital admission, of which 19 (35.8%) required intensive care unit level of care. Median follow-up was 50 (interquartile range, 25-59) days, with mortality reported in six (3.6%) patients. Risk factors identified for hospital admission were African American race (p < .001, odds ratio [OR] 4.00, 95% confidence interval [CI] 1.84-8.70), history of coronary artery disease (p = .031, OR 3.50, 95% CI 1.12-10.87), and maintenance immunosuppression with corticosteroids (p = .048, OR 2.00, 95% CI 1.01-4.00). In conclusion, contrary to that in the general population, we found a higher hospital admission rate in SOT recipients with omicron variant infection. Further studies to investigate the efficacy of newer treatments are necessary, even as outcomes continue to improve.
Collapse
Affiliation(s)
- Shweta Anjan
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA,Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA
| | - Akshay Khatri
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Julia Bini Viotti
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Teresa Cheung
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Leopoldo A. Cordova Garcia
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Jacques Simkins
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA,Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA
| | - Matthias Loebe
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Anita Phancao
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of MedicineDivision of CardiologyUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Christopher B. O'Brien
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of MedicineDivision of HepatologyUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Neeraj Sinha
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of MedicineDivision of PulmonologyUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Gaetano Ciancio
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Rodrigo M. Vianna
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of SurgeryUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - David Andrews
- Department of PathologyUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Lilian M. Abbo
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA,Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA
| | - Giselle Guerra
- Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA,Department of MedicineDivision of NephrologyUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA
| | - Yoichiro Natori
- Department of MedicineDivision of Infectious DiseaseUniversity of Miami Miller School of Medicine MiamiMiamiFloridaUSA,Miami Transplant InstituteJackson Health SystemMiamiFloridaUSA
| |
Collapse
|
|
19
|
Nimmo A, Gardiner D, Ushiro-Lumb I, Ravanan R, Forsythe JLR. The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic. Transplantation 2022; 106:1312-1329. [PMID: 35404911 PMCID: PMC9213067 DOI: 10.1097/tp.0000000000004151] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a major global impact on solid organ transplantation (SOT). An estimated 16% global reduction in transplant activity occurred over the course of 2020, most markedly impacting kidney transplant and living donor programs, resulting in substantial knock-on effects for waitlisted patients. The increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection risk and excess deaths in transplant candidates has resulted in substantial effort to prioritize the safe restart and continuation of transplant programs over the second year of the pandemic, with transplant rates returning towards prepandemic levels. Over the past 2 y, COVID-19 mortality in SOT recipients has fallen from 20%-25% to 8%-10%, attributed to the increased and early availability of SARS-CoV-2 testing, adherence to nonpharmaceutical interventions, development of novel treatments, and vaccination. Despite these positive steps, transplant programs and SOT recipients continue to face challenges. Vaccine efficacy in SOT recipients is substantially lower than the general population and SOT recipients remain at an increased risk of adverse outcomes if they develop COVID-19. SOT recipients and transplant teams need to remain vigilant and ongoing adherence to nonpharmaceutical interventions appears essential. In this review, we summarize the global impact of COVID-19 on transplant activity, donor evaluation, and patient outcomes over the past 2 y, discuss the current strategies aimed at preventing and treating SARS-CoV-2 infection in SOT recipients, and based on lessons learnt from this pandemic, propose steps the transplant community could consider as preparation for future pandemics.
Collapse
Affiliation(s)
- Ailish Nimmo
- Renal Department, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | | | | | | | | |
Collapse
|
|
20
|
Chow KM, Maggiore U, Dor FJ. Ethical Issues in Kidney Transplant and Donation During COVID-19 Pandemic. Semin Nephrol 2022; 42:151272. [PMID: 36577645 PMCID: PMC9283694 DOI: 10.1016/j.semnephrol.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The coronavirus disease-19 pandemic caused by the severe acute respiratory syndrome coronavirus has faced the transplant community with unprecedented clinical challenges in a highly vulnerable patient category. These were associated with many uncertainties for patients and health care professionals and prompted many ethical debates regarding the safe delivery of kidney transplantation. In this article, we highlight some of the most important ethical questions that were raised during the pandemic and attempt to analyze ethical arguments in light of core principles of medical ethics to either suspend or continue kidney transplantation, and to mandate vaccination in transplant patients, transplant candidates, and, finally, health care providers. We have come up with frameworks to deal responsibly with these ethical challenges, and formulated recommendations to cope with the issues imposed on patients and transplant professionals.
Collapse
Affiliation(s)
- Kai-Ming Chow
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Umberto Maggiore
- Dipartimento di Medicina e Chirurgia, Università di Parma, Unita’ Operativa Nefrologia, Azienda Ospedaliera-Universitaria Parma, Parma, Italy
| | - Frank J.M.F. Dor
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare National Health Service Trust, London, United Kingdom,Department of Surgery and Cancer, Imperial College, London, United Kingdom,Address reprint requests to Frank J.M.F. Dor, MD, PhD, FEBS(Hon), FRCS, Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare National Health Service Trust, Office 468, Hammersmith House, Hammersmith Hospital, Du Cane Road, W120HS London, United Kingdom
| |
Collapse
|
|
21
|
Agrawal D, Saigal S. Utilization of SARS-COV-2 positive donors and recipients for liver transplantation in the pandemic era - An evidence-based review. JOURNAL OF LIVER TRANSPLANTATION 2022; 7:100081. [PMID: 38620745 PMCID: PMC8915505 DOI: 10.1016/j.liver.2022.100081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 12/24/2022] Open
Abstract
The current SARS-COV-2 pandemic led to a drastic drop in liver donation and transplantation in DDLT and LDLT settings. Living donations have decreased more than deceased organ donation due to the need to protect the interest of donors. In the SARS-COV-2 pandemic, major professional societies worldwide recommended against the use of organs from donors with acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The basis for these recommendations are; SARS-CoV-2 could be transmitted to the recipient through organ transplantation and can result in severe manifestations; only limited effective targeted therapies are available, risk of transmission to the healthcare professionals, logistical limitations, and ethical concerns. In addition, end-stage liver disease patients on the waiting list represent vulnerable populations and are at higher risk for severe COVID-19 infection. Therefore, deferring life-saving transplants from COVID-positive donors during a pandemic may lead to more collateral damage by causing disease progression, increased death, and dropout from the waitlist. As this SARS-COV-2 pandemic is likely to stay with us for some time, we have to learn to co-exist with it. We believe that utilizing organs from mild/ asymptomatic COVID19 positive donors may expand the organ donor pool and mitigate disruptions in transplantation services during this pandemic.
Collapse
Affiliation(s)
- Dhiraj Agrawal
- Department of Gastroenterology and hepatology, PACE Hospitals, HITEC city, Hyderabad 500081, India
| | - Sanjiv Saigal
- Hepatology and Liver Transplant, Center for Liver & Biliary Sciences, Center of Gastroenterology, Hepatology & Endoscopy, Max Super Speciality Hospital, Saket, New Delhi 110017, India
| |
Collapse
|
|
22
|
Knihs NDS, Paim SMS, Magalhães ALP, Pessoa JLE, Wachholz LF, Santos JLGD, Silva ELD, Schirmer J. Care actions in obtaining tissues and organs during the COVID-19 pandemic: a mixed methods study. Rev Bras Enferm 2022; 75Suppl 1:e20210613. [PMID: 35674547 DOI: 10.1590/0034-7167-2021-0613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to map health care actions in the organ and tissue donation process in Brazilian regions during the COVID-19 pandemic. METHODS a mixed methods study. Data collection was performed simultaneously through an online questionnaire with 72 nurses. Descriptive statistical analysis and content analysis. RESULTS a total of 34.7% of professionals work in the state of São Paulo. The largest number of responses was from the Southeast region. Four categories emerged. The first addresses triage care actions; the second involves guidelines for SARS-CoV-2 prevention in potential donors; the third relates to the epidemiological screening of professionals; the fourth presents the scenario of donation training in pandemic times. CONCLUSION care actions are aimed at tracking the path taken until arrival at the hospital, assessing temperature and saturation curves, in addition to screening for signs and symptoms for SARS-CoV-2 contamination among professionals.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Janine Schirmer
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
| |
Collapse
|
|
23
|
Ufua DE, Olujobi OJ, Tahir H, Al-Faryan MAS, Matthew OA, Osabuohien E. Lean Entrepreneurship and SME Practice in a Post COVID-19 Pandemic Era: A Conceptual Discourse from Nigeria. GLOBAL JOURNAL OF FLEXIBLE SYSTEMS MANAGEMENT 2022; 23:331-344. [PMID: 37521252 PMCID: PMC9084273 DOI: 10.1007/s40171-022-00304-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 04/01/2022] [Indexed: 11/14/2022]
Abstract
This study investigates lean principles among Nigerian entrepreneurs and SME managers in the operational process in the aftermath of COVID-19 pandemic in Nigeria. It offers the panacea to the challenge of social-economic shocks and their adverse effects on SMEs' business activities in Nigeria. The study adopts a conceptual approach to investigate lean entrepreneurship practice by SMEs in Nigeria. It relies on data from extant literature, using a conceptual approach to examine the social-economic effects of COVID-19 pandemic and critical environmental factors on the lean entrepreneurship practice in Nigeria. Furthermore, the study explores the influence of lean practice among SMEs and entrepreneurs in Nigeria and suggests a broad model for lean entrepreneurial practice in post-COVID-19 pandemic Nigeria. Findings highlight the broad social-economic effects of COVID-19 pandemic and other challenges such as theft, host community pressure, weak legal system, and inadequate government policy support affect lean entrepreneurship practice. These factors constitute complex operational issues that would require the adoption of a more comprehensive approach to address. It also highlights crucial factors for post-COVID-19 pandemic SMEs' operational success in Nigeria due to deficits in infrastructure and regulatory efficiency for SMEs' operations to address the various challenges of business failures in Nigeria. The study suggests a lean SME and Entrepreneurial Practice model in the post-COVID-19 pandemic era. It emphasises the need to refocus the active interest of the lean entrepreneur on critical business sustainability. The study recommends a critical review of the internal operational process among practicing entrepreneurial businesses and a re-modification of public policies system that governs the operational functions of entrepreneurial practices for reasonable and resilient post-COVID-19 pandemic entrepreneurship practices that can support the SMEs and economic growth in Nigeria.
Collapse
Affiliation(s)
- Daniel E. Ufua
- Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
- Department of Business Management, College of Management and Social Sciences, Covenant University, Ota, Nigeria
- Honorary Research Fellow, ILMA University, Karachi, Pakistan
| | - Olusola J. Olujobi
- Department of Public and International Law, College of Law, Afe Babalola University, Ado- Ekiti, Ekiti State Nigeria
| | - Hammad Tahir
- Department of Business Administration, ILMA University, Karachi, Pakistan
| | - Mamdouh Abdulaziz Saleh Al-Faryan
- Department of Accounting and Financial Management, Faculty of Business and Law, University of Portsmouth, Portsmouth, UK
- Consultant in Economics and Finance, Riyadh, Saudi Arabia
| | - Oluwatoyin A. Matthew
- Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
- Department of Economics & Development Studies, College of Management and Social Sciences, Covenant University, Ota, Nigeria
| | - Evans Osabuohien
- Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
- Department of Economics & Development Studies, College of Management and Social Sciences, Covenant University, Ota, Nigeria
| |
Collapse
|
|
24
|
Kuramitsu K, Yamanaga S, Osawa R, Hibi T, Yoshikawa M, Toyoda M, Shimata K, Yosuke E, Ono M, Kenmochi T, Sogawa H, Natori Y, Yano H, Chen-Yoshikawa T, Yoshida K, Fukumoto T, Yuzawa K, Egawa H. Impact of COVID-19 on the Living Donor Liver and Kidney Transplantation Programs in Japan in 2020. Transpl Infect Dis 2022; 24:e13845. [PMID: 35505462 PMCID: PMC9348111 DOI: 10.1111/tid.13845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/13/2022] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
Background Although many transplant programs have been forced to suspend living donor transplants due to the emergence of coronavirus disease (COVID‐19), there are relatively few real‐time databases to assess center‐level transplant activities. We aimed to delineate the actual impact of COVID‐19 on living donor transplant programs and the resumption process in Japan. Methods In a nationwide survey, questionnaires were sent to 32 liver transplant programs that had performed at least more than one case of living donor liver transplantation in 2019 and 132 kidney transplant programs that had performed more than one living donor kidney transplantation in 2018. Results Thirty‐one (96.9%) and 125 (94.7%) liver and kidney transplant programs responded, respectively. In the early pandemic period, 67.7% (21/31) of liver programs and 29.8% (37/125) of kidney programs were able to maintain transplant activities similar to those during the pre‐pandemic period. After temporal suspension, 58.1% of kidney programs resumed their transplant activity after the number of local COVID‐19 cases peaked. Establishing institutional COVID‐19 screening, triage, and therapeutic management protocols was mandatory to resume transplant activity for 64.5% and 67.7% of liver and kidney programs, respectively. In the future wave of COVID‐19, 67.7% of liver programs would be affected by institutional COVID‐19 intensive care unit‐bound patient numbers, and 55.7% of kidney programs would stop if hospital‐acquired severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection spreads. Conclusions: This nationwide survey revealed for the first time how living donor liver and kidney transplant programs changed in response to the COVID‐19 pandemic in a country where living donor transplantations are predominant.
Collapse
Affiliation(s)
- Kaori Kuramitsu
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Graduate School of Medicine, Kobe University, Hyogo, Japan
| | - Shigeyoshi Yamanaga
- Department of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Ryosuke Osawa
- Department of Infectious Disease, Kameda Medical Center, Chiba, Japan
| | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University Hospital, Kumamoto, Japan
| | - Mikiko Yoshikawa
- Department of Transplant and Regenerative Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mariko Toyoda
- Department of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Keita Shimata
- Department of Pediatric Surgery and Transplantation, Kumamoto University Hospital, Kumamoto, Japan
| | - Ebisu Yosuke
- Department of Infectious Disease, Kameda Medical Center, Chiba, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Tokyo University, Tokyo, Japan
| | - Takashi Kenmochi
- Department of Transplantation, Fujita Health University, Aichi, Japan
| | - Hiroshi Sogawa
- Department of Surgery, Westchester Medical Center/New York Medical College, NY, USA
| | - Yoichiro Natori
- Division of Infectious Disease, Department of Medicine, University of Miami, FL, USA
| | - Harumi Yano
- Department of Public Health, International University of Health and Welfare, Chiba, Japan
| | | | - Kazunari Yoshida
- Department of Organ Transplant Medicine, Kitasato University, Kanagawa, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Graduate School of Medicine, Kobe University, Hyogo, Japan
| | - Kenji Yuzawa
- Department of Transplant Surgery, Mito Medical Center, Ibaraki, Japan
| | - Hiroto Egawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| |
Collapse
|
|
25
|
Subramanian V, Anderson C, Karp S, Pastan S, Gerber D, Locke J, Cohen A, Shah M, Casingal V, Strata R, Singh N, DuBay D, Dhanireddy K. COVID-19 and transplantation-Data censoring. Am J Transplant 2022; 22:1958-1962. [PMID: 35451211 PMCID: PMC9111342 DOI: 10.1111/ajt.17065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023]
Abstract
During the early wave of the COVID-19 pandemic, the Scientific Registry of Transplant Recipients (SRTR) designated a "black out" period between March 12, 2020, and June 12, 2020, for transplant outcomes reporting. We discuss the implications and potential bias it has introduced as it may selectively favor the outcomes for certain regions and harm other regions due to varied effects of different waves of COVID-19 infections across the United States.
Collapse
Affiliation(s)
| | | | - Seth Karp
- Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | | | - David Gerber
- University of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jayme Locke
- University of Alabama School of MedicineBirminghamAlabamaUSA
| | - Ari Cohen
- Ochsner Clinic FoundationJeffersonLouisianaUSA
| | - Malay Shah
- University of KentuckyLexingtonKentuckyUSA
| | | | - Robert Strata
- Atrium Health Wake Forest BaptistWinston‐SalemNorth CarolinaUSA
| | - Neeraj Singh
- Willis‐Knighton Medical CenterShreveportLouisianaUSA
| | - Derek DuBay
- Medical University of South CarolinaMt PleasantSouth CarolinaUSA
| | | |
Collapse
|
|
26
|
Van Slambrouck J, Van Raemdonck D, Wauters J, Vos R, Mombaerts P, Ceulemans LJ. Lung donation and SARS-CoV-2 transmission: Missed detection versus missed opportunity? Immun Inflamm Dis 2022; 10:e603. [PMID: 35349750 PMCID: PMC8939038 DOI: 10.1002/iid3.603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022] Open
Abstract
Point-of-care tests may play a valuable role in reducing the risk of donor-derived SARS-CoV-2 transmission in lung transplantation.
Collapse
Affiliation(s)
- Jan Van Slambrouck
- Department of Thoracic SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and MetabolismKU LeuvenLeuvenBelgium
| | - Dirk Van Raemdonck
- Department of Thoracic SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and MetabolismKU LeuvenLeuvenBelgium
| | - Joost Wauters
- Medical Intensive Care UnitUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Robin Vos
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and MetabolismKU LeuvenLeuvenBelgium
- Department of Respiratory DiseasesUniversity Hospitals LeuvenLeuvenBelgium
| | - Peter Mombaerts
- Max Planck Research Unit for NeurogeneticsFrankfurt am MainGermany
| | - Laurens J. Ceulemans
- Department of Thoracic SurgeryUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and MetabolismKU LeuvenLeuvenBelgium
| |
Collapse
|
|
27
|
Zhang M, Wang G, Li J, Hopp WJ, Lee DD. Pausing transplants in the face of a global pandemic: Patient survival implications. PRODUCTION AND OPERATIONS MANAGEMENT 2022; 32:POMS13697. [PMID: 35601839 PMCID: PMC9115406 DOI: 10.1111/poms.13697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/03/2022] [Indexed: 06/15/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID-19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant centers considered the possibility of slowing down and even potentially pausing all transplants. Many proposals regarding the need for pausing organ transplants exist; however, much remains unknown. Whereas the impact of the COVID-19 pandemic on the overall healthcare system is unknown, the potential impact of pausing organ transplants over a period can be estimated. This study presents a model for evaluating the impact of pausing liver transplants over a spectrum of model for end-stage liver disease-sodium (MELD-Na) scores. Our model accounts for two potential risks of a pause: (1) the waitlist mortality of all patients who do not receive liver transplants during the pause period, and (2) the impact of a longer waiting list due to the pause of liver transplants and the continuous accrual of new patients. Using over 12 years of liver transplant data from the United Network for Organ Sharing and a system of differential equations, we estimate the threshold probability above which a decision maker should pause liver transplants to reduce the loss of patient life months. We also compare different pause policies to illustrate the value of patient-specific and center-specific approaches. Finally, we analyze how capacity constraints affect the loss of patient life months and the length of the waiting list. The results of this study are useful to decision makers in deciding whether and how to pause organ transplants during a pandemic. The results are also useful to patients (and their care providers) who are waiting for organ transplants.
Collapse
Affiliation(s)
- Minmin Zhang
- Naveen Jindal School of ManagementUniversity of Texas at DallasRichardsonTexasUSA
| | - Guihua Wang
- Naveen Jindal School of ManagementUniversity of Texas at DallasRichardsonTexasUSA
| | - Jun Li
- Stephen M. Ross School of BusinessUniversity of MichiganAnn ArborMichiganUSA
| | - Wallace J. Hopp
- Stephen M. Ross School of BusinessUniversity of MichiganAnn ArborMichiganUSA
| | - David D. Lee
- Stritch School of MedicineLoyola University ChicagoMaywoodIllinoisUSA
| |
Collapse
|
|
28
|
Kemme S, Yoeli D, Sundaram SS, Adams MA, Feldman AG. Decreased access to pediatric liver transplantation during the COVID-19 pandemic. Pediatr Transplant 2022; 26:e14162. [PMID: 34633127 PMCID: PMC8646490 DOI: 10.1111/petr.14162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The COVID-19 pandemic has affected all aspects of the US healthcare system, including liver transplantation. The objective of this study was to understand national changes to pediatric liver transplantation during COVID-19. METHODS Using SRTR data, we compared waitlist additions, removals, and liver transplantations for pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). RESULTS Waitlist additions decreased by 25% during early COVID-19 (41.3/month vs. 55.4/month, p < .001) with black candidates most affected (p = .04). Children spent longer on the waitlist during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days, p < .001). There was a 38% decrease in liver transplantations during early COVID-19 (IRR 0.62, 95% CI 0.49-0.78), recovering to pre-pandemic rates during late COVID-19 (IRR 1.03, NS), and no change in percentage of living and deceased donors. White children had a 30% decrease in overall liver transplantation but no change in living donor liver transplantation (IRR 0.7, 95% CI 0.50-0.95; IRR 0.96, NS), while non-white children had a 44% decrease in overall liver transplantation (IRR 0.56, 95% CI 0.40-0.77) and 81% decrease in living donor liver transplantation (IRR 0.19, 95% CI 0.02-0.76). CONCLUSIONS The COVID-19 pandemic decreased access to pediatric liver transplantation, particularly in its early stage. There were no regional differences in liver transplantation during COVID-19 despite the increased national sharing of organs. While pediatric liver transplantation has resumed pre-pandemic levels, ongoing racial disparities must be addressed.
Collapse
Affiliation(s)
- Sarah Kemme
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Dor Yoeli
- Division of Transplant SurgeryColorado Center for Transplantation Care, Research and EducationUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Shikha S. Sundaram
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Megan A. Adams
- Division of Transplant SurgeryColorado Center for Transplantation Care, Research and EducationUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Amy G. Feldman
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| |
Collapse
|
|
29
|
Russo FP, Izzy M, Rammohan A, Kirchner VA, Di Maira T, Belli LS, Berg T, Berenguer MC, Polak WG. Global impact of the first wave of COVID-19 on liver transplant centers: A multi-society survey (EASL-ESOT/ELITA-ILTS). J Hepatol 2022; 76:364-370. [PMID: 34653592 PMCID: PMC8511875 DOI: 10.1016/j.jhep.2021.09.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/30/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The global impact of SARS-CoV-2 on liver transplantation (LT) practices across the world is unknown. The goal of this survey was to assess the impact of the pandemic on global LT practices. METHOD A prospective web-based survey (available online from 7th September 2020 to 31st December 2020) was proposed to the active members of the EASL-ESOT/ELITA-ILTS in the Americas (including North, Central, and South America) (R1), Europe (R2), and the rest of the world (R3). The survey comprised 4 parts concerning transplant processes, therapy, living donors, and organ procurement. RESULTS Of the 470 transplant centers reached, 128 answered each part of the survey, 29 centers (23%), 64 centers (50%), and 35 centers (27%) from R1, R2, and R3, respectively. When we compared the practices during the first 6 months of the pandemic in 2020 with those a year earlier in 2019, statistically significant differences were found in the number of patients added to the waiting list (WL), WL mortality, and the number of LTs performed. At the regional level, we found that in R2 the number of LTs was significantly higher in 2019 (p <0.01), while R3 had more patients listed, higher WL mortality, and more LTs performed before the pandemic. Countries severely affected by the pandemic ("hit" countries) had a lower number of WL patients (p = 0.009) and LTs (p = 0.002) during the pandemic. Interestingly, WL mortality was still higher in the "non-hit" countries in 2020 compared to 2019 (p = 0.022). CONCLUSION The first wave of the pandemic differentially impacted LT practices across the world, especially with detrimental effects on the "hit" countries. Modifications to the policies of recipient and donor selection, organ retrieval, and postoperative recipient management were adopted at a regional or national level. LAY SUMMARY The health emergency caused by the coronavirus pandemic has dramatically changed clinical practice during the pandemic. The first wave of the pandemic impacted liver transplantation differently across the world, with particularly detrimental effects on the countries badly hit by the virus. The resilience of the entire transplant network has enabled continued organ donation and transplantation, ultimately improving the lives of patients with end-stage liver disease.
Collapse
Affiliation(s)
- Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, University Hospital Padua, Padua Italy.
| | - Manhal Izzy
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ashwin Rammohan
- The Institute of Liver Disease & Transplantation, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Varvara A. Kirchner
- Department of Surgery, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Tommaso Di Maira
- Liver Transplantation and Hepatology Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain,ISS La Fe, Valencia, Spain
| | - Luca Saverio Belli
- Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University, Medical Center, 04103 Leipzig, Germany
| | - Marina Carmen Berenguer
- Liver Transplantation and Hepatology Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain,CIBERehd, Instituto de Salud Carlos III, Madrid, Spain,ISS La Fe, Valencia, Spain
| | - Wojciech Grzegorz Polak
- Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC Transplant Institute, University Medical Centre, Rotterdam, the Netherlands
| |
Collapse
|
|
30
|
Sandal S, Massie A, Boyarsky B, Chiang TPY, Thavorn K, Segev DL, Cantarovich M. Impact of the COVID-19 pandemic on transplantation by income level and cumulative COVID-19 incidence: a multinational survey study. BMJ Open 2022; 12:e055367. [PMID: 35022176 PMCID: PMC8756076 DOI: 10.1136/bmjopen-2021-055367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic significantly affected the provisions of health services to necessary but deprioritised fields, such as transplantation. Many programmes had to ramp-down their activity, which may significantly affect transplant volumes. We aimed to pragmatically analyse measures of transplant activity and compare them by a country's income level and cumulative COVID-19 incidence (CCI). DESIGN, SETTING AND PARTICIPANTS From June to September 2020, we surveyed transplant physicians identified as key informants in their programmes. Of the 1267 eligible physicians, 40.5% from 71 countries participated. OUTCOME Four pragmatic measures of transplant activity. RESULTS Overall, 46.5% of the programmes from high-income countries anticipate being able to maintain >75% of their transplant volume compared with 31.6% of the programmes from upper-middle-income countries, and with 21.7% from low/lower-middle-income countries (p<0.001). This could be because more programmes in high-income countries reported being able to perform transplantation/s (86.8%%-58.5%-67.9%, p<0.001), maintain prepandemic deceased donor offers (31.0%%-14.2%-26.4%, p<0.01) and avoid a ramp down phase (30.9%%-19.7%-8.3%, p<0.001), respectively. In a multivariable analysis that adjusted for CCI, programmes in upper-middle-income countries (adjusted OR, aOR=0.47, 95% CI 0.27 to 0.81) and low/lower-middle-income countries (aOR 0.33, 95% CI 0.16 to 0.67) had lower odds of being able to maintain >75% of their transplant volume, compared with programmes in high-income countries. Again, this could be attributed to lower-income being associated with 3.3-3.9 higher odds of performing no transplantation/s, 66%-68% lower odds of maintaining prepandemic donor offers and 37%-76% lower odds of avoiding ramp-down of transplantation. Overall, CCI was not associated with these measures. CONCLUSIONS The impact of the pandemic on transplantation was more in lower-income countries, independent of the COVID-19 burden. Given the lag of 1-2 years in objective data being reported by global registries, our findings may inform practice and policy. Transplant programmes in lower-income countries may need more effort to rebuild disrupted services and recuperate from the pandemic even if their COVID-19 burden was low.
Collapse
Affiliation(s)
- Shaifali Sandal
- Department of Medicine, Division of Nephrology, Multi-organ Transplant Program, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Allan Massie
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Brian Boyarsky
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Kednapa Thavorn
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Dorry L Segev
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marcelo Cantarovich
- Department of Medicine, Division of Nephrology, Multi-organ Transplant Program, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| |
Collapse
|
|
31
|
Munting A, Manuel O. Viral infections in lung transplantation. J Thorac Dis 2022; 13:6673-6694. [PMID: 34992844 PMCID: PMC8662465 DOI: 10.21037/jtd-2021-24] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/21/2021] [Indexed: 12/15/2022]
Abstract
Viral infections account for up to 30% of all infectious complications in lung transplant recipients, remaining a significant cause of morbidity and even mortality. Impact of viral infections is not only due to the direct effects of viral replication, but also to immunologically-mediated lung injury that may lead to acute rejection and chronic lung allograft dysfunction. This has particularly been seen in infections caused by herpesviruses and respiratory viruses. The implementation of universal preventive measures against cytomegalovirus (CMV) and influenza (by means of antiviral prophylaxis and vaccination, respectively) and administration of early antiviral treatment have reduced the burden of these diseases and potentially their role in affecting allograft outcomes. New antivirals against CMV for prophylaxis and for treatment of antiviral-resistant CMV infection are currently being evaluated in transplant recipients, and may continue to improve the management of CMV in lung transplant recipients. However, new therapeutic and preventive strategies are highly needed for other viruses such as respiratory syncytial virus (RSV) or parainfluenza virus (PIV), including new antivirals and vaccines. This is particularly important in the advent of the COVID-19 pandemic, for which several unanswered questions remain, in particular on the best antiviral and immunomodulatory regimen for decreasing mortality specifically in lung transplant recipients. In conclusion, the appropriate management of viral complications after transplantation remain an essential step to continue improving survival and quality of life of lung transplant recipients.
Collapse
Affiliation(s)
- Aline Munting
- Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Oriol Manuel
- Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland.,Transplantation Center, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
|
32
|
Vitale G, Gitto S, Marra F, Morelli MC. From advanced disease to transplantation: an overview of the liver at the time of COVID-19 pandemic. Intern Emerg Med 2022; 17:15-24. [PMID: 34245423 PMCID: PMC8271284 DOI: 10.1007/s11739-021-02801-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 02/08/2023]
Abstract
In 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) also known as coronavirus disease 2019 (COVID-19) disrupted global health, causing hundreds of thousands of deaths worldwide. The liver injury appears to be one of the possible systemic manifestations of COVID-19 disease although the mechanisms causing such injury are not entirely clear. At the beginning of the pandemic, patients with chronic diseases, such as liver cirrhosis, or special populations, such as liver transplant recipients, were considered at higher risk of complications and poor clinical outcomes. Thus, the national transplant programmes have been severely hampered by the COVID-19 pandemic. Furthermore, liver transplant patients are potentially more vulnerable to SARS-CoV-2 infection due to immune suppression, ageing, and metabolic or cardiovascular comorbidities. This review analyses the increasing amounts of data collected in recent months concerning liver cirrhosis and liver transplants to understand if this finding is still relevant with respect to COVID-19 manifestations.
Collapse
Affiliation(s)
- Giovanni Vitale
- grid.6292.f0000 0004 1757 1758Internal Medicine Unit for the Treatment of Severe Organ Failure, Dipartimento delle insufficienze d’organo e dei trapianti, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Via Albertoni 15, Bologna, Italy
| | - Stefano Gitto
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fabio Marra
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Cristina Morelli
- grid.6292.f0000 0004 1757 1758Internal Medicine Unit for the Treatment of Severe Organ Failure, Dipartimento delle insufficienze d’organo e dei trapianti, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Via Albertoni 15, Bologna, Italy
| |
Collapse
|
|
33
|
Varshney M, Choudhury A, Sahoo B, Pamecha V, Sinha P, Patil N, Mohapatra N, Sharma V, Kumar R. Impact of covid-19 pandemic on quality of life and psychosocial difficulties among liver transplant recipients. J Family Med Prim Care 2022; 11:744-750. [PMID: 35360795 PMCID: PMC8963630 DOI: 10.4103/jfmpc.jfmpc_1798_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The first wave of the COVID-19 pandemic affected health in all domains i.e., physical, mental, and social aspects. Liver transplant (LT) recipients faced a multitude of challenges during the first wave of lockdown. The aim was to identify the psychosocial difficulties and quality of life during the first year of the pandemic. Methods: A cross-sectional survey was conducted on LT recipients with a predefined structured questionnaire that included clinical, COVID-19 anxiety scale, and Post-Transplant Quality of life questionnaire (pLTQ). Results: A total of 109 patients were studied; with a mean age of 50.5 ± 11.1 years, with a median post-transplant follow-up of 52.4 months and a live donor transplant in the majority (79.8%). Almost all (99.1%) could come to the hospital for regular follow-up, prior to the pandemic. But during the first wave only 57% could maintain planned hospital visits and about 88% could not pursue their regular activities, and 39% missed their routine exercise because of imposed restrictions. Similarly, financial implications were responsible for 4% defaulting from treatment; while 7.3% managed by curtailing supportive drugs (on their own) leading to deranged liver tests in 4.6%; requiring immediate attention. The psychosocial difficulties raised the stress of pandemic (median score 18), and impacted quality of life (mean total pLTQ score 4.7 ± 0.9) Conclusions: For LT recipients, the first wave of COVID-19 pandemic affected their physical, mental, financial, and social wellbeing; in addition to the disease itself. Awareness, psychosocial support, and comprehensive care are some unmet needs for this special group; especially when it is expected that subsequent waves may continue to occur.
Collapse
|
|
34
|
Nacif LS, Fernandes MR, Waisberg DR, Pinheiro RS, Rocha-Santos V, Galvão F, Andraus W, Carneiro-D'Albuquerque L. Liver transplant after SARS-CoV-2 infection: A systematic review. Clinics (Sao Paulo) 2022; 77:100042. [PMID: 35870265 PMCID: PMC9040369 DOI: 10.1016/j.clinsp.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/26/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The Coronavirus 19 (COVID-19) pandemic has dramatically impacted liver organ transplantation. The American Society of Transplantation recommends a minimum of 28 days after symptom resolution for organ donation. However, the exact time for transplantation for recipients is unknown. Considering that mortality on the waiting list for patients with MELD >25 or fulminant hepatitis is higher than that of COVID-19, the best time for surgery after SARS-CoV-2 infection remains undetermined. This study aims to expand the current knowledge regarding the Liver Transplantation (LT) time for patients after COVID-19 and to provide transplant physicians with essential decision-making tools to manage these critically ill patients during the pandemic. METHODS Systematic review of patients who underwent liver transplantation after diagnosis of COVID-19. The MEDLINE, PubMed, Cochrane, Lilacs, Embase, and Scielo databases were searched until June 20, 2021. The MESH terms used were "COVID-19" and "Liver transplantation". RESULTS 558 articles were found; of these 13 articles and a total of 18 cases of COVID-19 prior to liver transplantation were reported. The mean age was 38.7±14.6, with male prevalence. Most had mild symptoms of COVID. Five patients have specific treatment for COVID-19 with convalescent plasm or remdesivir/oseltamivir, just one patient received hydroxychloroquine, and 12 patients received only symptomatic treatment. The median time between COVID-19 to LT was 19 days (13.5‒44.5). Deceased donor liver transplantation accounted for 61% of cases, while living donor transplantation was 39%. CONCLUSION Despite the concerns regarding the postoperative evolution, the mortality of patients with high MELD or fulminant hepatitis transplanted shortly after COVID-19 diagnosis does not seem to be higher. (PROSPERO, registration number = CRD42021261790).
Collapse
Affiliation(s)
- Lucas S Nacif
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Michel Ribeiro Fernandes
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Daniel R Waisberg
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rafael S Pinheiro
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vinicius Rocha-Santos
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Flávio Galvão
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wellington Andraus
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luiz Carneiro-D'Albuquerque
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
|
35
|
Testino G, Vignoli T, Patussi V, Allosio P, Amendola MF, Aricò S, Baselice A, Balbinot P, Campanile V, Fanucchi T, Macciò L, Meneguzzi C, Mioni D, Parisi M, Renzetti D, Rossin R, Gandin C, Bottaro LC, Caio G, Lungaro L, Zoli G, Scafato E, Caputo F. Alcohol use disorder in the COVID-19 era: Position paper of the Italian Society on Alcohol (SIA). Addict Biol 2022; 27:e13090. [PMID: 34532923 PMCID: PMC8646667 DOI: 10.1111/adb.13090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022]
Abstract
Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment.
Collapse
Affiliation(s)
- Gianni Testino
- Unit of Addiction and Hepatology, Regional Centre on AlcoholASL3 San Martino HospitalGenoaItaly
| | - Teo Vignoli
- Unit of Addiction TreatmentLugo (Ravenna)Italy
| | | | | | | | - Sarino Aricò
- Gastroenterology UnitMauriziano HospitalTorinoItaly
| | | | - Patrizia Balbinot
- Unit of Addiction and Hepatology, Regional Centre on AlcoholASL3 San Martino HospitalGenoaItaly
| | | | | | | | | | | | | | - Doda Renzetti
- Department of Internal MedicineMater Dei HospitalBariItaly
| | | | - Claudia Gandin
- National Observatory on AlcoholNational Institute of HealthRomeItaly
| | | | - Giacomo Caio
- Centre for the Study and Treatment of Alcohol‐Related DiseasesDepartment of Translational Medicine, University of FerraraFerraraItaly
| | - Lisa Lungaro
- Centre for the Study and Treatment of Alcohol‐Related DiseasesDepartment of Translational Medicine, University of FerraraFerraraItaly
| | - Giorgio Zoli
- Centre for the Study and Treatment of Alcohol‐Related DiseasesDepartment of Translational Medicine, University of FerraraFerraraItaly
- Department of Internal Medicine, SS Annunziata Hospital, Cento (Ferrara)University of FerraraFerraraItaly
| | - Emanuele Scafato
- National Observatory on AlcoholNational Institute of HealthRomeItaly
| | - Fabio Caputo
- Centre for the Study and Treatment of Alcohol‐Related DiseasesDepartment of Translational Medicine, University of FerraraFerraraItaly
- Department of Internal Medicine, SS Annunziata Hospital, Cento (Ferrara)University of FerraraFerraraItaly
| |
Collapse
|
|
36
|
Abdellatif AA, Mogawer MS, El- Shazli M, El-Karaksy H, Salah A, Abdel-Maqsod A, El-Amir M, Said M, Zayed N, Hosny K, Eldeen HG, Osman AMA, Mansour DA, Nabil A, Abdel-Ghani A, Mogahed EA, Yasin NA. Resuming post living donor liver transplantation in the COVID-19 pandemic: real-life experience, single-center experience. EGYPTIAN LIVER JOURNAL 2021; 11:92. [PMID: 34956680 PMCID: PMC8686346 DOI: 10.1186/s43066-021-00153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/07/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Solid organ transplantation (SOT) service has been disrupted during the current coronavirus disease 2019 (COVID-19) pandemic, which deferred the service in most centers worldwide. As the pandemic persists, there will be an urgency to identify the best and safest practices for resuming activities as areas re-open. Resuming activity is a difficult issue, in particular, the decision of reopening after a period of slowing down or complete cessation of activities. OBJECTIVES To share our experience in resuming living donor liver transplantation (LDLT) in the context of the COVID-19 pandemic in the Liver Transplantation Unit of El-Manial Specialized Hospital, Cairo University, Egypt, and to review the obstacles that we have faced. MATERIAL AND METHODS This study is a single-center study. We resumed LDLT by the 26th of August 2020 after a period of closure from the 1st of March 2020. We have taken a lot of steps in order to prevent COVID-19 transmission among transplant patients and healthcare workers (HCWs). RESULTS In our study, we reported three LDLT recipients, once resuming the transplantation till now. All our recipients and donors tested negative for SARS-CoV-2 by nasopharyngeal RT-PCR a day before the transplantation. Unfortunately, one of them developed COVID-19 infection. We managed rapidly to isolate him in a single room, restricting one team of HCWs to deal with him with strict personal protective measures. Finally, the patient improved and was discharged in a good condition. The second patient ran a smooth course apart from FK neurotoxicity which improved with proper management. The third patient experienced a sharp rise in bilirubin and transaminases on day 14 that was attributed to drug toxicity vs. rejection and managed by discontinuing the offending drugs and pulse steroids. In addition, one of our head nurses tested positive for SARS-CoV-2 that was manageable with self-isolation. CONCLUSION Careful patient, donor, personnel screening is mandatory. Adequate supply of personal protective equipments, effective infection control policies, and appropriate administrative modifications are needed for a safe return of LDLT practice.
Collapse
Affiliation(s)
- Abeer Awad Abdellatif
- Hepatogastroenterology, Liver Transplantation Unit, Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Street, Cairo, PO: 11451 Egypt
| | - Mohamad Sherif Mogawer
- Hepatogastroenterology, Liver Transplantation Unit, Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Street, Cairo, PO: 11451 Egypt
| | - Mostafa El- Shazli
- Department of General Surgery, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanaa El-Karaksy
- Pediatrics Department, Liver Transplantation Unit, Cairo University, Cairo, Egypt
| | - Ayman Salah
- Department of General Surgery, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany Abdel-Maqsod
- Hepatogastroenterology, Liver Transplantation Unit, Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Street, Cairo, PO: 11451 Egypt
| | - Mona El-Amir
- Hepatogastroenterology, Liver Transplantation Unit, Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Street, Cairo, PO: 11451 Egypt
| | - Mohamed Said
- Endemic Medicine, Hepatogastroenterology, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa Zayed
- Endemic Medicine Department, Liver Transplantation unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Karim Hosny
- Pediatrics Department, Liver Transplantation Unit, Cairo University, Cairo, Egypt
| | - Hadeel Gamal Eldeen
- Endemic Hepatology and Gastroenterology, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman M. A. Osman
- General & HPB Surgery, Department of General Surgery, Unit of Hepatobiliary Surgery, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa A. Mansour
- Department of General Surgery, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Nabil
- Department of General Surgery, Liver Transplantation Unit, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Abdel-Ghani
- Hepatogastroenterology, Liver Transplantation Unit, Internal Medicine Department, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Street, Cairo, PO: 11451 Egypt
| | - Engy A. Mogahed
- Pediatrics Department, Liver Transplantation Unit, Cairo University, Cairo, Egypt
| | - Noha A. Yasin
- Pediatrics Department, Liver Transplantation Unit, Cairo University, Cairo, Egypt
| |
Collapse
|
|
37
|
Fonseca EA, Feier F, Pugliese R, Freitas AF, Porta G, Miura I, Baggio V, Kondo M, Benavides M, Vincenzi R, Roda K, Oliveira CV, Chapchap P, Seda‐Neto J. Pediatric liver transplantation activity in a high-volume program during the COVID-19 pandemic in Brazil. Pediatr Transplant 2021; 25:e14112. [PMID: 34396644 PMCID: PMC8420104 DOI: 10.1111/petr.14112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The impact of the COVID pandemic on liver transplant (LT) programs varied among countries. Few data are available about that impact in pediatric liver transplant (PLT) programs. This study aimed at comparing the data of our program in Brazil (2019 vs. 2020). METHODS Retrospective cohort study. RESULTS One hundred and seventy-four PLT were performed in the period (93% living donors). Patients were divided into two groups according to the LT date: pre-COVID-19 period (march/2019-February/2020) and COVID-19 period (March/2020-February 2021). In the pre-COVID-19 period, 97 LTs were performed, and 77 LTs were performed in the COVID-19 period. Patients in the COVID-19 period were younger (10.9 months vs. 16 months, p 0.009), had higher PELD scores (15 vs. 14, p 0.04), more ascites (66.2 vs. 51.5%, p 0.03), and more frequently hospitalized before LT (27.3 vs. 17.5%). However, there was no difference in post-LT complications, retransplantation nor survival rates. Six (6.2%) patients from pre-COVID-19 period were COVID positive at a median of 15.5 months (14-17.5), and 6 (7.8%) patients from COVID-19 period were COVID positive at a median of 3 months (20 days-6 months) from LT. There was neither mortality nor complications in those patients. Four (33%) were hospitalized, and one had prolonged intubation. Four (33%) were asymptomatic, 4 (33%) had upper airways symptoms, and the remaining had gastrointestinal symptoms. CONCLUSION Overall, PLT was not affected during COVID-19 period. Even though patients from COVID-19 period were sicker, there was no significant impact in LT outcomes. All the recipients who tested positive for COVID had a favorable outcome.
Collapse
Affiliation(s)
- Eduardo A. Fonseca
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Flavia Feier
- Hepatology and Liver TransplantationSanta Casa de Porto AlegrePorto AlegreBrazil
| | - Renata Pugliese
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Aline F. Freitas
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Gilda Porta
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Irene Miura
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Vera Baggio
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Mario Kondo
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Marcel Benavides
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Rodrigo Vincenzi
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Karina Roda
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Caio V. Oliveira
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - Paulo Chapchap
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| | - João Seda‐Neto
- Hepatology and Liver TransplantationHospital Sírio‐LibanêsSão PauloBrazil,Hepatology and Liver Transplantation A. C. Camargo Cancer CenterSão PauloBrazil
| |
Collapse
|
|
38
|
Whitsett M, Ortiz V, Weinberg EM. CON: Liver Transplantation in the Times of COVID-19: Patients with COVID-19 Infection Should not Undergo Liver Transplantation. Clin Liver Dis (Hoboken) 2021; 18:233-236. [PMID: 34840724 PMCID: PMC8605695 DOI: 10.1002/cld.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 02/04/2023] Open
Affiliation(s)
- Maureen Whitsett
- Department of Gastroenterology and HepatologyHospital of the University of PennsylvaniaPhiladelphiaPAUSA,Department of MedicineHospital of the University of PennsylvaniaPhiladelphiaPAUSA
| | - Vivian Ortiz
- Department of Gastroenterology and HepatologyHospital of the University of PennsylvaniaPhiladelphiaPAUSA,Department of MedicineHospital of the University of PennsylvaniaPhiladelphiaPAUSA
| | - Ethan M. Weinberg
- Department of Gastroenterology and HepatologyHospital of the University of PennsylvaniaPhiladelphiaPAUSA,Department of MedicineHospital of the University of PennsylvaniaPhiladelphiaPAUSA
| |
Collapse
|
|
39
|
|
|
40
|
Vijayakumar M, Janani B, Kannappan P, Renganathan S, Al-Ghamdi S, Alsaidan M, Abdelaziz MA, Peer Mohideen A, Shahid M, Ramesh T. In silico identification of potential inhibitors against main protease of SARS-CoV-2 6LU7 from Andrographis panniculata via molecular docking, binding energy calculations and molecular dynamics simulation studies. Saudi J Biol Sci 2021; 29:18-29. [PMID: 34729030 PMCID: PMC8555113 DOI: 10.1016/j.sjbs.2021.10.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/12/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background The ongoing global outbreak of new corona virus (SARS-CoV-2) has been recognized as global public health concern since it causes high morbidity and mortality every day. Due to the rapid spreading and re-emerging, we need to find a potent drug against SARS-CoV-2. Synthetic drugs, such as hydroxychloroquine, remdisivir have paid more attention and the effects of these drugs are still under investigation, due to their severe side effects. Therefore, the aim of the present study was performed to identify the potential inhibitor against main protease SARS-CoV-2 6LU7. Objective In this study, RO5, ADME properties, molecular dynamic simulations and free binding energy prediction were mainly investigated. Results The molecular docking study findings revealed that andrographolide had higher binding affinity among the selected natural diterpenoids compared to co-crystal native ligand inhibitor N3. The persistent inhibition of Ki for diterpenoids was analogous. Furthermore, the simulations of molecular dynamics and free binding energy findings have shown that andrographolide possesses a large amount of dynamic properties such as stability, flexibility and binding energy. Conclusion In conclusion, findings of the current study suggest that selected diterpenoids were predicted to be the significant phytonutrient-based inhibitor against SARS-CoV-2 6LU7 (Mpro). However, preclinical and clinical trials are needed for the further scientific validation before use.
Collapse
Affiliation(s)
- Mayakrishnan Vijayakumar
- Laboratory of Cell and Molecular Biology, Grassland and Forage Science Division, National Institute of Animal Science, Rural Development Administration, Cheonan-si, Chungcheongnam-do 31000, Republic of Korea
| | - Balakarthikeyan Janani
- Department of Biochemistry, PSG College of Arts and Science (Autonomous), Affiliated to Bharathiar University, Coimbatore 641014, Tamil Nadu, India
| | - Priya Kannappan
- Department of Biochemistry, PSG College of Arts and Science (Autonomous), Affiliated to Bharathiar University, Coimbatore 641014, Tamil Nadu, India
| | - Senthil Renganathan
- Department of Bioinformatics, Marudupandiyar College, Thanjavur 613 403, Tamil Nadu, India.,Lysine Biotech Private Limited, Periyar Technology Incubator, DST Business Incubator, Periyar Maniammai Institute of Science and Technology (PMIST), Vallam, Thanjavur 613403, Tamil Nadu, India
| | - Sameer Al-Ghamdi
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia
| | - Mohammed Alsaidan
- Internal Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia
| | - Mohamed A Abdelaziz
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia.,Department of Medical Physiology, College of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abubucker Peer Mohideen
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia
| | - Mohammad Shahid
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia
| | - Thiyagarajan Ramesh
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj-11942, Kingdom of Saudi Arabia
| |
Collapse
|
|
41
|
Omar AS, Kaddoura R, Orabi B, Hanoura S. Impact of COVID-19 pandemic on liver, liver diseases, and liver transplantation programs in intensive care units. World J Hepatol 2021; 13:1215-1233. [PMID: 34786163 PMCID: PMC8568568 DOI: 10.4254/wjh.v13.i10.1215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/25/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Emerging worldwide data have been suggesting that coronavirus disease 2019 (COVID-19) pandemic consequences are not limited to the respiratory and cardiovascular systems but encompass adverse gastrointestinal manifestations including acute liver injury as well. Severe cases of liver injury associated with higher fatality rates were observed in critically ill patients with COVID-19. Intensive care units (ICU) have been the center of disposition of severe cases of COVID-19. This review discusses the pathogenesis of acute liver injury in ICU patients with COVID-19, and analyzes its prevalence, consequences, possible drug-induced liver injury, and the impact of the pandemic on liver diseases and transplantation programs.
Collapse
Affiliation(s)
- Amr Salah Omar
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Critical Care Medicine, Beni Suef University, Beni Suef 61355, Egypt
- Department of Medicine, Weill Cornell Medical College, Doha 3050, Qatar
| | - Rasha Kaddoura
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Bassant Orabi
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Samy Hanoura
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Anesthesia, Alazhar University, Cairo 6050, Egypt
- Department of Anesthesia, Weill Cornell Medical College, Doha 3050, DA, Qatar
| |
Collapse
|
|
42
|
Jayant K, Reccia I, Bachul PJ, Al-Salmay Y, Pyda JS, Podda M, Perez-Gutierrez A, Dor FJMF, Becker Y, di Sabato D, LaMattina J, Barth R, Fung J, Witkowski P. The Impact of COVID-19 on Kidney Transplant Recipients in Pre-Vaccination and Delta Strain Era: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:4533. [PMID: 34640552 PMCID: PMC8509345 DOI: 10.3390/jcm10194533] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 01/08/2023] Open
Abstract
Herein, we performed a meta-analysis of published clinical outcomes of corona virus disease 2019 (COVID-19) in hospitalized kidney transplant recipients. A systematic database search was conducted between December 1, 2019 and April 20, 2020. We analyzed 48 studies comprising 3137 kidney transplant recipients with COVID-19. Fever (77%), cough (65%), dyspnea (48%), and gastrointestinal symptoms (28%) were predominant on hospital admission. The most common comorbidities were hypertension (83%), diabetes mellitus (34%), and cardiac disease (23%). The pooled prevalence of acute respiratory distress syndrome and acute kidney injury were 58% and 48%, respectively. Invasive ventilation and dialysis were required in 24% and 22% patients, respectively. In-hospital mortality rate was as high as 21%, and increased to over 50% for patients in intensive care unit (ICU) or requiring invasive ventilation. Risk of mortality in patients with acute respiratory distress syndrome (ARDS), on mechanical ventilation, and ICU admission was increased: OR = 19.59, OR = 3.80, and OR = 13.39, respectively. Mortality risk in the elderly was OR = 3.90; however, no such association was observed in terms of time since transplantation and gender. Fever, cough, dyspnea, and gastrointestinal symptoms were common on admission for COVID-19 in kidney transplant patients. Mortality was as high as 20% and increased to over 50% in patients in ICU and required invasive ventilation.
Collapse
Affiliation(s)
- Kumar Jayant
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Isabella Reccia
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Piotr J. Bachul
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Yaser Al-Salmay
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Jordan S. Pyda
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Mauro Podda
- Department of Emergency Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University Hospital Policlinico Duilio Casula, 09124 Cagliari, Italy;
| | - Angelica Perez-Gutierrez
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Frank J. M. F. Dor
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Yolanda Becker
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Diego di Sabato
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - John LaMattina
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Rolf Barth
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - John Fung
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Piotr Witkowski
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| |
Collapse
|
|
43
|
Mikolasevic I, Bozic D, Pavić T, Ruzic A, Hauser G, Radic M, Radic-Kristo D, Razov-Radas M, Puljiz Z, Milic S. Liver disease in the era of COVID-19: Is the worst yet to come? World J Gastroenterol 2021; 27:6039-6052. [PMID: 34629818 PMCID: PMC8476340 DOI: 10.3748/wjg.v27.i36.6039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/18/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
The global social, economic and political crises related to coronavirus disease 2019 (COVID-19) presumably had more indirect than direct negative impacts on health systems. Drastic lifestyle changes, social isolation and distancing, and individual and global financial crises resulted in robust populations forfeiting healthy habits and seeking comfort in alcoholic beverages, drugs and unhealthy diets. The inevitable consequences are increases in the incidence of nonalcoholic fatty liver disease, viral hepatitis, acute alcoholic hepatitis, liver cirrhosis decompensation and ultimately liver-related mortality. The inaccessibility of regular clinical and sonographic monitoring systems has caused difficulties in the treatment of patients with chronic liver disease (CLD) and has prevented prompt hepatocellular carcinoma detection and treatment. A dramatic reduction in the number of liver donors and the transformation of numerous transplantation centers into COVID-19 units drastically decreased the rate of orthotopic liver transplantation. The indirect, unavoidable effects of the COVID-19 pandemic in the following years have yet to be determined. Substantial efforts in the management of patients with liver disease in order to overcome the inevitable COVID-19-related morbidity and mortality that will follow have yet to be initiated. Several questions regarding the impact of the COVID-19 pandemic on liver disease remain. The most important question for general CLD patients is: How will the modification of clinical practice during this pandemic affect the outcomes of CLD patients? This article reviews the influence of COVID-19 on patients with liver disease during the pandemic, with particular emphasis on the disease course associated with pandemic resolution.
Collapse
Affiliation(s)
- Ivana Mikolasevic
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Rijeka 51000, Croatia
- Department of Gastroenterology, University Hospital Merkur, Zagreb 10000, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
| | - Dorotea Bozic
- Department for Gastroenterology and Hepatology, University Hospital Center Split, Split 21000, Croatia
| | - Tajana Pavić
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Sestre Milosrdnice University Hospital Center, Zagreb 10000, Croatia
| | - Alen Ruzic
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
- Clinic for Cardiology, University Hospital Center Rijeka, Rijeka 51000, Croatia
| | - Goran Hauser
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Rijeka 51000, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
- Faculty of Health Studies, University of Rijeka, Rijeka 51000, Croatia
| | | | - Delfa Radic-Kristo
- Faculty of Medicine, Zagreb 10000, Croatia
- Department of Hematology, University Hospital Merkur, Zagreb 10000, Croatia
| | | | - Zeljko Puljiz
- Department for Gastroenterology and Hepatology, University Hospital Center Split, Split 21000, Croatia
- University of Split, School of Medicine, Split 21000, Croatia
| | - Sandra Milic
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Rijeka 51000, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
| |
Collapse
|
|
44
|
Nassar M, Nso N, Ariyaratnam J, Sandhu J, Mohamed M, Baraka B, Ibrahim A, Alfishawy M, Zheng D, Bhangoo H, Soliman KM, Li M, Rizzo V, Daoud A. Coronavirus disease 2019 and renal transplantation. World J Clin Cases 2021; 9:7986-7997. [PMID: 34621855 PMCID: PMC8462194 DOI: 10.12998/wjcc.v9.i27.7986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/17/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Ever since the severe acute respiratory syndrome virus causing coronavirus disease 2019 (COVID-19) struck the world, global health strategies have changed significantly. According to the Centers for Disease Control and Prevention, kidney transplant recipients are stratified as being high risk of developing fatal illness from COVID-19 infection. Kidney transplant is the gold-standard treatment for end-stage kidney disease subjects. During the pandemic, significant concerns have emerged regarding continuation of kidney transplant surgeries and management of kidney transplant recipients post-transplant. The added risk of immunosuppression in this cohort was and remains a theoretical concern, posing a potential risk of transplantation rather than benefit. This comprehensive review aims to cover most of the faced challenges in kidney transplantation in different stages of the pandemic. In addition, it will elucidate the epidemiology, nature, course of the disease, surgical consideration in donors and recipients as well as role of immunosuppression and management of COVID-19 infected kidney transplant recipients during these extraordinary circumstances.
Collapse
Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Jonathan Ariyaratnam
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Jasmine Sandhu
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Mahmoud Mohamed
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Bahaaeldin Baraka
- Department of Oncology, Southend University Hospital, NHS Foundation Trust, Essex SS0 0RY, United Kingdom
| | - Atif Ibrahim
- Renal Division, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Mostafa Alfishawy
- Infectious Diseases, Infectious Diseases Consultants and Academic Researchers of Egypt IDCARE, Cairo 0000, Egypt
| | - David Zheng
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Harangad Bhangoo
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Karim M Soliman
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Matthew Li
- Department of Clinical Pharmacy, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Vincent Rizzo
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Ahmed Daoud
- Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt
| |
Collapse
|
|
45
|
Mihalj M, Mosbahi S, Schmidli J, Heinisch PP, Reineke D, Schoenhoff F, Kadner A, Schefold JC, Räber L, Potapov EV, Luedi MM. Providing safe perioperative care in cardiac surgery during the COVID-19 pandemic. Best Pract Res Clin Anaesthesiol 2021; 35:321-332. [PMID: 34511222 PMCID: PMC7826053 DOI: 10.1016/j.bpa.2021.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 10/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has potentiated the need for implementation of strict safety measures in the medical care of surgical patients - and especially in cardiac surgery patients, who are at a higher risk of COVID-19-associated morbidity and mortality. Such measures not only require minimization of patients' exposure to COVID-19 but also careful balancing of the risks of postponing nonemergent surgical procedures and providing appropriate and timely surgical care. We provide an overview of current evidence for preoperative strategies used in cardiac surgery patients, including risk stratification, telemedicine, logistical challenges during inpatient care, appropriate screening capacity, and decision-making on when to safely operate on COVID-19 patients. Further, we focus on perioperative measures such as safe operating room management and address the dilemma over when to perform cardiovascular surgical procedures in patients at risk.
Collapse
Affiliation(s)
- Maks Mihalj
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Selim Mosbahi
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Juerg Schmidli
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Paul Philipp Heinisch
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - David Reineke
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Florian Schoenhoff
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Alexander Kadner
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Joerg C Schefold
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Lorenz Räber
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| | - Evgenij V Potapov
- Department of Cardiothoracic and Vascular Surgery, German Heart Center, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Markus M Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
| |
Collapse
|
|
46
|
Kwapisz M, Małkowski P, Tronina O, Wasiak D, Czerwiński J, Polak WG, Kosieradzki M. Effects of the COVID-19 Pandemic on Solid Organ Transplantation During 2020 in Poland Compared with Countries in Western Europe, Asia, and North America: A Review. Med Sci Monit 2021; 27:e932025. [PMID: 34480012 PMCID: PMC8425269 DOI: 10.12659/msm.932025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/18/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began in March 2020, affected organ donor acceptance and rates of heart, lung, kidney, and liver transplants worldwide. According to data reported to POLTRANSPLANT, the number of solid organ transplants decreased by over 35% and the number of patients enlisted de novo for organ transplantation was reduced to 70% of its pre-COVID-19 volume in Poland. Most transplant centers in Western Europe and the USA have also drastically reduced their activity when compared to the pre-pandemic era. Areas of high SARS-CoV-2 infection incidence, like Italy, Spain, and France, were most affected. Significant decreases in organ donation and number of transplant procedures and increase in waitlist deaths have been noted due to overload of the healthcare system as well as uncertainty of donor SARS-CoV-2 status. Intensive care unit bed shortages and less intensive care resources available for donor management are major factors limiting access to organ procurement. The impact of the COVID-19 outbreak on transplant activities was not so adverse in Asia, as a result of a strategy based on experience gained during a previous SARS pandemic. This review aims to compare the effects of the COVID-19 pandemic on solid organ transplantation during 2020 in Poland with countries in Western Europe, North America, and Asia.
Collapse
Affiliation(s)
- Magdalena Kwapisz
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Małkowski
- Department of Surgical and Transplantation Nursing and Extracorporeal Therapies, Medical University of Warsaw, Warsaw, Poland
| | - Olga Tronina
- Department of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Dariusz Wasiak
- Department of Surgical and Transplantation Nursing and Extracorporeal Therapies, Medical University of Warsaw, Warsaw, Poland
| | - Jarosław Czerwiński
- Department of Emergency Medicine, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Polish Transplant Coordinating Center POLTRANSPLANT, Warsaw, Poland
| | - Wojciech G. Polak
- Department of Surgery, Division of Hepato-Pancreato-Biliary (HPB) and Transplant Surgery, Erasmus MC, Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maciej Kosieradzki
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
|
47
|
MacConmara M, Wang B, Patel MS, Hwang CS, DeGregorio L, Shah J, Hanish SI, Desai D, Lynch R, Tanriover B, Zeh H, Vagefi PA. Liver Transplantation in the Time of a Pandemic: A Widening of the Racial and Socioeconomic Health Care Gap During COVID-19. Ann Surg 2021; 274:427-433. [PMID: 34183513 PMCID: PMC8354487 DOI: 10.1097/sla.0000000000004994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE During the initial wave of the COVID-19 pandemic, organ transplantation was classified a CMS Tier 3b procedure which should not be postponed. The differential impact of the pandemic on access to liver transplantation was assessed. SUMMARY BACKGROUND DATA Disparities in organ access and transplant outcomes among vulnerable populations have served as obstacles in liver transplantation. METHODS Using UNOS STARfile data, adult waitlisted candidates were identified from March 1, 2020 to November 30, 2020 (n = 21,702 pandemic) and March 1, 2019 to November 30, 2019 (n = 22,797 pre-pandemic), and further categorized and analyzed by time periods: March to May (Period 1), June to August (Period 2), and September to November (Period 3). Comparisons between pandemic and pre-pandemic groups included: Minority status, demographics, diagnosis, MELD, insurance type, and transplant center characteristics. Liver transplant centers (n = 113) were divided into tertiles by volume (small, medium, large) for further analyses. Multivariable logistic regression was fitted to assess odds of transplant. Competing risk regression was used to predict probability of removal from the waitlist due to transplantation or death and sickness. Additional temporal analyses were performed to assess changes in outcomes over the course of the pandemic. RESULTS During Period 1 of the pandemic, Minorities showed greater reduction in both listing (-14% vs -12% Whites), and transplant (-15% vs -7% Whites), despite a higher median MELD at transplant (23 vs 20 Whites, P < 0.001). Of candidates with public insurance, Minorities demonstrated an 18.5% decrease in transplants during Period 1 (vs -8% Whites). Although large programs increased transplants during Period 1, accounting for 61.5% of liver transplants versus 53.4% pre-pandemic (P < 0.001), Minorities constituted significantly fewer transplants at these programs during this time period (27.7% pandemic vs 31.7% pre-pandemic, P = 0.04). Although improvements in disparities in candidate listings, removals, and transplants were observed during Periods 2 and 3, the adjusted odds ratio of transplant for Minorities was 0.89 (95% CI 0.83-0.96, P = 0.001) over the entire pandemic period. CONCLUSIONS COVID-19's effect on access to liver transplantation has been ubiquitous. However, Minorities, especially those with public insurance, have been disproportionately affected. Importantly, despite the uncertainty and challenges, our systems have remarkable resiliency, as demonstrated by the temporal improvements observed during Periods 2 and 3. As the pandemic persists, and the aftermath ensues, health care systems must consciously strive to identify and equitably serve vulnerable populations.
Collapse
Affiliation(s)
- Malcolm MacConmara
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Benjamin Wang
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Madhukar S Patel
- Department of Transplantation, University of Toronto, Toronto, ON, Canada
| | - Christine S Hwang
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Lucia DeGregorio
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jigesh Shah
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Steven I Hanish
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Dev Desai
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Raymond Lynch
- Division of Transplantation, Department of Surgery, Emory University, Atlanta, GA
| | - Bekir Tanriover
- Division of Nephrology, Department of Medicine, University of Arizona, Tuscon, AZ
| | - Herbert Zeh
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Parsia A Vagefi
- Division of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| |
Collapse
|
|
48
|
Bhatt AS, Adler ED, Albert NM, Anyanwu A, Bhadelia N, Cooper LT, Correa A, Defilippis EM, Joyce E, Sauer AJ, Solomon SD, Vardeny O, Yancy C, Lala A. Coronavirus Disease-2019 and Heart Failure: A Scientific Statement From the Heart Failure Society of America. J Card Fail 2021; 28:93-112. [PMID: 34481067 PMCID: PMC8408888 DOI: 10.1016/j.cardfail.2021.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Ankeet S Bhatt
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric D Adler
- Department of Cardiology, University of California, San Diego, California
| | - Nancy M Albert
- Nursing Institute and Heart, Vascular and Thoracic Institute; Cleveland Clinic, Cleveland, Ohio
| | - Anelechi Anyanwu
- Department of Cardiovascular Surgery, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nahid Bhadelia
- Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts; Center for Emerging Infectious Diseases Policy and Research (CEID), Boston University, Boston, Massachusetts
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida
| | - Ashish Correa
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ersilia M Defilippis
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Emer Joyce
- Department of Cardiovascular Medicine, Mater University Hospital, and School of Medicine, University College Dublin, Ireland
| | - Andrew J Sauer
- Department of Cardiovascular Medicine, University of Kansas School of Medicine, Kansas City, Kansas
| | - Scott D Solomon
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Orly Vardeny
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, and University of Minnesota, Minneapolis
| | - Clyde Yancy
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anuradha Lala
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
| |
Collapse
|
|
49
|
Alfishawy M, Nso N, Nassar M, Ariyaratnam J, Bhuiyan S, Siddiqui RS, Li M, Chung H, Al Balakosy A, Alqassieh A, Fülöp T, Rizzo V, Daoud A, Soliman KM. Liver transplantation during global COVID-19 pandemic. World J Clin Cases 2021; 9:6608-6623. [PMID: 34447809 PMCID: PMC8362541 DOI: 10.12998/wjcc.v9.i23.6608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/02/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory disease respiratory syndrome coronavirus-2 has significantly impacted the health care systems globally. Liver transplantation (LT) has faced an unequivocal challenge during this unprecedented time. This targeted review aims to cover most of the clinical issues, challenges and concerns about LT during the COVID-19 pandemic and discuss the most updated literature on this rapidly emerging subject.
Collapse
Affiliation(s)
- Mostafa Alfishawy
- Infectious Diseases, Infectious Diseases Consultants and Academic Researchers of Egypt IDCARE, Cairo 0000, Egypt
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Jonathan Ariyaratnam
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Sakil Bhuiyan
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Raheel S Siddiqui
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Matthew Li
- Clinical pharmacy department, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Howard Chung
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Amira Al Balakosy
- Tropical Medicine Department, Ain Shams University, Cairo 11517, Egypt
| | - Ahmed Alqassieh
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Tibor Fülöp
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Vincent Rizzo
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Ahmed Daoud
- Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt
| | - Karim M Soliman
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| |
Collapse
|
|
50
|
Frattaroli P, Anjan S, Coro A, Simkins J, Vianna R, Morsi M, Abbo L, Guerra G, Natori Y. Is it safe to perform abdominal transplantation from SARS-CoV-2 polymerase chain reaction positive donors? Transpl Infect Dis 2021; 23:e13688. [PMID: 34258844 PMCID: PMC8420592 DOI: 10.1111/tid.13688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Paola Frattaroli
- Department of Medicine, Division of Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Shweta Anjan
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ana Coro
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA
| | - Jacques Simkins
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rodrigo Vianna
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mahmoud Morsi
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lilian Abbo
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Giselle Guerra
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Nephrology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Yoichiro Natori
- Miami Transplant Institute, Jackson Health System, Miami, Florida, USA.,Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|