The impact of COVID-19 on liver transplantation programs in Austria.
Wien Klin Wochenschr
; 2022 Nov 11.
Article
in English
| MEDLINE | ID: covidwho-2115694
ABSTRACT
BACKGROUND:
Coronavirus disease of 2019 (COVID-19) has affected liver disease management. The impact of the COVID-19 pandemic on the Austrian orthotopic liver transplantation (OLT) programs, however, has not been systematically investigated.METHODS:
All patients listed for OLT in Austria during 2020-2021 were studied. Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing, vaccinations, infections, mortality and the overall number of OLTs (vs. pre-COVID-19 2015-2019) were analyzed.RESULTS:
Overall, 490 patients (median age 58.0 years, 70.4% men, hepatocellular carcinoma 27.3%) were listed for OLT in Austria in 2020-2021. Alcohol-related cirrhosis (35.3%), cholestatic (16.7%) and viral liver disease (13.9%) were the main etiologies. Of the patients 61.2% underwent OLT and 8.8% died while on the waiting list. The number of OLTs performed during COVID-19 (2020 nâ¯= 150; 2021 nâ¯= 150) remained unchanged compared to pre-COVID-19 (median nâ¯= 152). Among waiting list patients, 7.7% (nâ¯= 31/401) were diagnosed with COVID-19 and 7 (22.6%) of these patients died. By the end of 2021, 45.1% (nâ¯= 176/390; 82.8% mRNA vaccinations) and 28.8% (105/365) of patients received 2 and 3 SARS-CoV2 vaccinations, respectively. After two SARS-CoV2 vaccinations, antibodies more often remained undetectable in patients vaccinated post-OLT (25.6% vs. 6.5% in patients vaccinated pre-OLT; pâ¯= 0.034). Patients with three vaccinations after OLT had lower antibody titers than patients vaccinated pre-OLT (post-OLT 513.5, IQR 44.4-2500.0 vs. pre-OLT 2500.0, IQR 1462.0-2500.0 BAU/mL; pâ¯= 0.020).CONCLUSION:
The number of OLTs in Austria remained unchanged during COVID-19. SARS-CoV2 infections were rare but associated with high mortality in patients on the Austrian OLT waiting lists. SARS-CoV2 vaccination rates at the end of 2021 were suboptimal, while serological response was better in patients vaccinated pre-OLT vs. post-OLT.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Etiology study
/
Experimental Studies
Topics:
Vaccines
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
S00508-022-02105-z
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