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Liver transplantation from active COVID-19 donors: A lifesaving opportunity worth grasping?
Romagnoli, Renato; Gruttadauria, Salvatore; Tisone, Giuseppe; Maria Ettorre, Giuseppe; De Carlis, Luciano; Martini, Silvia; Tandoi, Francesco; Trapani, Silvia; Saracco, Margherita; Luca, Angelo; Manzia, Tommaso Maria; Visco Comandini, Ubaldo; De Carlis, Riccardo; Ghisetti, Valeria; Cavallo, Rossana; Cardillo, Massimo; Grossi, Paolo Antonio.
  • Romagnoli R; Liver Transplant Center -General Surgery 2U, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Gruttadauria S; Abdominal Surgery and Organ Transplantation Unit, ISMETT, Palermo, Italy.
  • Tisone G; Surgical Sciences and Medical Sciences, University of Rome-Tor Vergata, Rome, Italy.
  • Maria Ettorre G; POIT Transplant Department, San Camillo Hospital and National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
  • De Carlis L; General Surgery and Abdominal Transplantation Unit, Hepatology, University of Milano-Bicocca and Niguarda-Cà Granda Hospital, Milan, Italy.
  • Martini S; Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Tandoi F; Liver Transplant Center -General Surgery 2U, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Trapani S; Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy.
  • Saracco M; Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Luca A; Abdominal Surgery and Organ Transplantation Unit, ISMETT, Palermo, Italy.
  • Manzia TM; Surgical Sciences and Medical Sciences, University of Rome-Tor Vergata, Rome, Italy.
  • Visco Comandini U; POIT Transplant Department, San Camillo Hospital and National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
  • De Carlis R; General Surgery and Abdominal Transplantation Unit, Hepatology, University of Milano-Bicocca and Niguarda-Cà Granda Hospital, Milan, Italy.
  • Ghisetti V; Laboratory of Microbiology and Virology, Ospedale Amedeo di Savoia, ASL "Città di Torino", Turin, Italy.
  • Cavallo R; Microbiology and Virology Unit, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Cardillo M; Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy.
  • Grossi PA; Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.
Am J Transplant ; 21(12): 3919-3925, 2021 12.
Article in English | MEDLINE | ID: covidwho-1381082
ABSTRACT
COVID-19 pandemic dramatically impacted transplantation landscape. Scientific societies recommend against the use of donors with active SARS-CoV-2 infection. Italian Transplant Authority recommended to test recipients/donors for SARS-CoV-2-RNA immediately before liver transplant (LT) and, starting from November 2020, grafts from deceased donors with active SARS-CoV-2 infection were allowed to be considered for urgent-need transplant candidates with active/resolved COVID-19. We present the results of the first 10 LTs with active COVID-19 donors within an Italian multicenter series. Only two recipients had a positive molecular test at LT and one of them remained positive up to 21 days post-LT. None of the other eight recipients was found to be SARS-CoV-2 positive during follow-up. IgG against SARS-CoV-2 at LT were positive in 80% (8/10) of recipients, and 71% (5/7) showed neutralizing antibodies, expression of protective immunity related to recent COVID-19. In addition, testing for SARS-CoV-2 RNA on donors' liver biopsy at transplantation was negative in 100% (9/9), suggesting a very low risk of transmission with LT. Immunosuppression regimen remained unchanged, according to standard protocol. Despite the small number of cases, these data suggest that transplanting livers from donors with active COVID-19 in informed candidates with SARS-CoV-2 immunity, might contribute to safely increase the donor pool.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / COVID-19 Type of study: Cohort study / Prognostic study Limits: Humans Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2021 Document Type: Article Affiliation country: Ajt.16823

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / COVID-19 Type of study: Cohort study / Prognostic study Limits: Humans Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2021 Document Type: Article Affiliation country: Ajt.16823