Liver transplant immunosuppression during the covid-19 pandemic. / Inmunosupresión en el trasplante hepático en la era covid-19.
Gastroenterol Hepatol
; 43(8): 457-463, 2020 Oct.
Article
in English, Spanish
| MEDLINE | ID: covidwho-639589
ABSTRACT
SARS-CoV-2 infection has produced a pandemic with serious consequences for our health care system. Although liver transplant patients represent only a minority of the population, the hepatologists who follow these patients have tried to coordinate efforts to produce a protocol the management of immunosuppression during SARS-CoV-2 infection. Although there are no solid studies to support general recommendations, experiences with other viral infections (hepatitis C, cytomegalovirus) suggest that management of immunosuppression without mycophenolate mofetil or m-Tor inhibitors (drugs that are also associated with leukopenia and lymphopenia) may be beneficial. It is also important to pay attention to possible drug interactions, especially in the case of tacrolimus, with some of the treatments with antiviral effect given in the context of COVID 19 (lopinavir/ritonavir, azithromycin). Finally, the immunosuppressive effect of immunomodulating drugs (tocilizumab and similar) administered to patients with severe lung disease should be taken into account. The mechanisms of action of the different immunosuppressive drugs are reviewed in this article, as well as their potential effect on SARS-CoV-2 infection, and suggests guidelines for the management of immunosuppression.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Immunosuppression Therapy
/
Liver Transplantation
/
Coronavirus Infections
/
Pandemics
/
Betacoronavirus
/
Immunosuppressive Agents
Type of study:
Observational study
/
Qualitative research
Language:
English
/
Spanish
Journal:
Gastroenterol Hepatol
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS