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COVID-19 in liver transplant candidates: wait-list outcomes and post-transplant course

Title: COVID-19 in liver transplant candidates: wait-list outcomes and post-transplant course
Authors: Perricone, G; Duvoux, C; Mazzarelli, C; Vigano, R; Facchetti, R; Cortesi, P; Iacob, S; Radenne, S; Patrono, D; Berlakovich, GA; Hann, A; Pasulo, L; Castel, L; Faitot, F; DETRY, Olivier; Invernizzi, F; Magini, G; De Simone, P; Kounis, I; Morelli, MC; Diaz, F; Erczon, BG; Loinaz, C; Johnston, C; Elkrief, L; Fondevilla, C; Polak, W; Belli, L
Source: Transplant International, 34 (S1 OP232), 41 (2021-08); ESOT 2021 Milan, Milan, Italy [IT], Du 29 aout au 1 septembre 2021
Publisher Information: Blackwell
Publication Year: 2021
Collection: University of Liège: ORBi (Open Repository and Bibliography)
Subject Terms: Human health sciences; Surgery; Gastroenterology & hepatology; Sciences de la santé humaine; Chirurgie; Gastroentérologie & hépatologie
Description: peer reviewed ; Background: The impact of prior SARS-CoV-2 infection on patients on the waiting list for liver transplantation (LT) and on their post-LT course is presently unknown. Methods: Data from adult LT candidates with laboratory confirmed SARSCoV- 2 infection was collected across Europe and all consecutive patients with symptomatic COVID-19 were included in the analysis. Results: From February 21st to November 20th, 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centers in 10 European countries were collected, with 113 having symptomatic COVID-19. Thirtythree (29.2%) were managed as outpatients, 80 (70.8%) required hospitalization including admission to the intensive care unit (28/80, 35%). Thirtyseven (37/113, 32.7%) patients died after a median of 18 (10-30) days, respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not change between first (35.3%, 95% CI 23.9-50.0) and second wave (26.0%, 95% CI 16.2-40.2). Multivariable Cox regression analysis showed MELD score !15 (MELD15-19:HR 6.09 95%CI 2.01-18.44; MELD ! 20:HR 5.21, 95%CI 1.76-15.45) and dyspnea on presentation (HR:4.1, 95%CI 2.09-8.06) being the two negative independent factors for mortality. Twenty-six patient received a LT after a median time of 78.5 (IQR:44-102) days and 25 are alive after a median follow-up of 118 days (IQR:31-170). Conclusions: Mortality of LT candidates with symptomatic COVID-19 was high (32.7%) peaking at 45% in decompensated cirrhotic with MELD > 15 and did not significantly differ between the 2 waves of the pandemic, respiratory failure being the major cause of death thus supporting high priority for vaccination. Prior SARS-CoV-2 infection did not affect early post-transplant survival (96%). ª
Document Type: conference object; report
Language: English
ISSN: 0934-0874; 1432-2277
Relation: urn:issn:0934-0874; urn:issn:1432-2277; https://orbi.uliege.be/handle/2268/262800; info:hdl:2268/262800; https://orbi.uliege.be/bitstream/2268/262800/1/OP232.pdf
Availability: https://orbi.uliege.be/handle/2268/262800; https://orbi.uliege.be/bitstream/2268/262800/1/OP232.pdf
Rights: open access ; http://purl.org/coar/access_right/c_abf2 ; info:eu-repo/semantics/openAccess
Accession Number: edsbas.C61F1B1F
Database: BASE