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Liver transplantation for acute liver failure in a SARS-CoV-2 PCR-positive patient.
Yohanathan, Lavanya; Campioli, Cristina C; Mousa, Omar Y; Watt, Kymberly; Friedman, Daniel Z P; Shah, Vijay; Ramkissoon, Resham; Hines, Alexander S; Kamath, Patrick S; Razonable, Raymund R; Badley, Andrew D; DeMartino, Erin S; Joyner, Michael J; Graham, Rondell; Vergidis, Paschalis; Simonetto, Doug A; Sanchez, William; Taner, Timucin; Heimbach, Julie K; Beam, Elena; Leise, Michael D.
  • Yohanathan L; Division of Transplant Surgery, The William J. Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.
  • Campioli CC; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
  • Mousa OY; Division of Gastroenterology, Mayo Clinic Health System, Mankato, Minnesota, USA.
  • Watt K; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Friedman DZP; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Shah V; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
  • Ramkissoon R; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Hines AS; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Kamath PS; Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Razonable RR; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Badley AD; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
  • DeMartino ES; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
  • Joyner MJ; Division of Pulmonology and Critical Care, Mayo Clinic Rochester, Minnesota, USA.
  • Graham R; Department of Anesthesia, Mayo Clinic, Rochester, Minnesota, USA.
  • Vergidis P; Department ofLaboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
  • Simonetto DA; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
  • Sanchez W; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Taner T; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
  • Heimbach JK; Division of Transplant Surgery, The William J. Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.
  • Beam E; Division of Transplant Surgery, The William J. Von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota, USA.
  • Leise MD; Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA.
Am J Transplant ; 21(8): 2890-2894, 2021 08.
Article in English | MEDLINE | ID: covidwho-1297494
ABSTRACT
Current guidelines recommend deferring liver transplantation (LT) in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection until clinical improvement occurs and two PCR tests collected at least 24 hours apart are negative. We report a case of an 18-year-old, previously healthy African-American woman diagnosed with COVID-19, who presents with acute liver failure (ALF) requiring urgent LT in the context of SARS-CoV-2 polymerase chain reaction (PCR) positivity. The patient was thought to have acute Wilsonian crisis on the basis of hemolytic anemia, alkaline phosphatasebilirubin ratio <4, ASTALT ratio >2.2, elevated serum copper, and low uric acid, although an unusual presentation of COVID-19 causing ALF could not be excluded. After meeting criteria for status 1a listing, the patient underwent successful LT, despite ongoing SARS-CoV-2 PCR positivity. Remdesivir was given immediately posttransplant, and mycophenolate mofetil was withheld initially and the SARS-CoV-2 PCR test eventually became negative. Three months following transplantation, the patient has made a near-complete recovery. This case highlights that COVID-19 with SARS-CoV-2 PCR positivity may not be an absolute contraindication for transplantation in ALF. Criteria for patient selection and timing of LT amid the COVID-19 pandemic need to be validated in future studies.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Liver Transplantation / Liver Failure, Acute / COVID-19 Subject: Liver Transplantation / Liver Failure, Acute / COVID-19 Type of study: Case report / Etiology study Language: English Journal: Am J Transplant Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Liver Transplantation / Liver Failure, Acute / COVID-19 Subject: Liver Transplantation / Liver Failure, Acute / COVID-19 Type of study: Case report / Etiology study Language: English Journal: Am J Transplant Year: 2021
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