ABSTRACT
Protecting immunosuppressed patients during infectious disease outbreaks is crucial. During this novel coronavirus disease 2019 pandemic, preserving "clean areas" in hospitals assisting organ transplant recipients is key to protect them and to preserve transplantation activity. Evidence suggests that asymptomatic carriers might transmit the SARS-CoV-2, challenging the implementation of transmission preventive strategies. We report a single-center experience using universal SARS-CoV-2 screening for all inpatients and newly admitted patients to an Organ Transplant Unit located in a region with significantly high community-based transmission.
Subject(s)
COVID-19/diagnosis , Carrier State/diagnosis , Cross Infection/prevention & control , Organ Transplantation , Adult , Aged , Brazil , COVID-19/complications , COVID-19/physiopathology , COVID-19/prevention & control , COVID-19 Nucleic Acid Testing , Child , End Stage Liver Disease/complications , Female , Hospital Units , Humans , Kidney Failure, Chronic/complications , Kidney Transplantation , Liver Transplantation , Male , Mass Screening , Middle Aged , Patient Isolation , Personal Protective Equipment , SARS-CoV-2 , Waiting ListsABSTRACT
BACKGROUND: Liver transplantation has become an effective treatment for selected patients with hepatocellular carcinoma with excellent outcomes. More recent reports have described improved outcomes in liver transplantation in a subset of patients with other malignancies like hilar cholangiocarcinoma, unresectable hepatic epithelioid hemangioendothelioma and hepatic metastasis from neuroendocrine tumors. However, hepatic angiosarcoma remains an absolute contraindication to liver transplantation because of the poor outcome. OBJECTIVES: The present study aims to describe liver transplantation for non-hepatocellular carcinoma malignancy. METHODS: A retrospective analysis of patients and review of the literature was performed. RESULTS: A total of 5 patients with non-hepatocellular carcinoma malignancy on explants histopathologic findings were identified. They presented hepatic epithelioid hemangioendothelioma (1), neuroendocrine tumor (1), angiosarcoma (1) and cholangiocarcinoma (2). The mean length of follow-up was 22.8 ± 37.67 (range, 2-90 months). Of 5 patients evaluated, 3 patients remain with stable graft function. CONCLUSION: Future investigations are necessary to redefine the indications of liver transplantations to treat non-hepatocellular carcinoma malignancy and its limitation.
