Afridi Sikandar Aziz*

Gambat Institute of Medical Sciences, Pakistan

*Corresponding Author: Afridi Sikandar Aziz, Gambat Institute of Medical Sciences, Pakistan.

Received: April 05, 2021; Published: May 17, 2021

Abstract

Background and Aims: The novel Coronavirus (COVID-19) pandemic with rapidly rising number of cases and high mortality massively affected living donor liver transplantation in Pakistan. The study aims at providing an insight into the transplantation in era of pandemic, its effects on LDLT in postoperative period.

Methods: All the patients listed for LDLT at PAQSJIMS from March 1^st to June 30^th 2020 were re-evaluated for LLDLT after an initial complete halt and mortality of 3, in terms CTP, MELD, COVID PCR and CT chest.

Results: 54 patients with Child C, MELD above 15 and negative PCR/HRCT underwent LDLT. 6 (5 recipients and 1 donor) out of 70 listed tested positive on PCR, were deferred for surgery and followed. Majority of recipients were males in their forties to sixties, with normal BMI, and no comorbidities, and underwent LDLT for chronic viral hepatitis with decompensated cirrhosis (HBV+ HDV, HBV, HCV) and unresectable hepatocellular carcinoma. 5 Recipients (no donors) were diagnosed with SARS clinically, 4 tested positive on PCR and 1 had CT findings highly suggestive of COVID infection. Mortality was 2/5, caused by MOF in patient with prolonged illness, and sudden cardiac death in relatively well patient.

Conclusion: In conclusion, COVID 19 can have an atypical clinical presentation in postliver transplant patients, patients may be pre-symptomatic or asymptomatic and can have cardiac arrhythmias. Symptomatic patients may not necessarily have Positive PCRs, HRCT findings should be considered in all symptomatic patients, before labelling them COVID negative based on PCR. Strictly following SOPs can reduce transmission of COVID-19.

Keywords: Diabetes Mellitus; Metabolism; Visceral Fat; Insulin; Cholesterol

References

1. Coronavirus disease (COVID-19). Update 20th September 2020. World health organization (2020).
2. Waris AU Khan., et al. “COVID-19 outbreak: current scenario of Pakistan”. New Microbes and New Infections 35 (2020): 100681.
3. COVID-19 pandemic. Humanity needs leadership and solidarity to defeat the coronavirus”. United nations development program (2020).
4. Akdur A., et al. “Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience”. Experimental and Clinical Transplantation 3 (2020): 270-274.
5. Di Maira T and Berenguer M. “COVID-19 and liver transplantation”. Nature Reviews Gastroenterology and Hepatology (2020).
6. Chang MC., et al. “Risk factors for disease progression in COVID-19 patients”. BMC Infectious Diseases 20 (2020): 445.
7. Cascella M., et al. “Features, Evaluation and Treatment Coronavirus (COVID-19) (2020).
8. Guan WJ., et al. “Clinical Characteristics of Coronavirus Disease 2019 in China”. The New England Journal of Medicine 382 (2020): 1708-1720.
9. Wang Y., et al. “Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China”. The Journal of Infectious Diseases (2020).
10. Kuck KH. “Arrhythmias and sudden cardiac death in the COVID-19 pandemic. Arrhythmien und plötzlicher Herztod in der COVID-19-Pandemie”. Herz4 (2020): 325-326.
11. Shirazi S., et al. “Sudden cardiac death in COVID-19 patients, a report of three cases”. Future Cardiology (2020): 1479-6678.
12. Pan X., et al. “Asymptomatic cases in a family cluster with SARS-CoV-2 infection”. The Lancet Infectious Diseases 20 (2020): 410-411.
13. Bai Y., et al. “Presumed Asymptomatic Carrier Transmission of COVID-19”. The Journal of the American Medical Association (2020).
14. Mizumoto K., et al. “Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020”. Eurosurveillance (2020): 25.
15. Tong ZD., et al. “Potential Presymptomatic Transmission of SARS-CoV-2, Zhejiang Province, China, 2020”. Emerging Infectious Diseases 26 (2020): 1052-1054.
16. Cascella M., et al. “Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (2020).
17. Guan WJ., et al. “Clinical characteristics of coronavirus disease 2019 in China”. The New England Journal of Medicine 382 (2020): 1708-1720.
18. Wang Y., et al. “Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China”. The Journal of Infectious Diseases (2020).
19. Harrison G., et al. “Mortality statistics in England and Wales: the SARS-CoV-2 paradox”. Journal of International Medical Research 6 (2020): 300060520931298.
20. Roussel Y., et al. “SARS-CoV-2: fear versus data”. International Journal of Antimicrobial Agents 5 (2020): 105947.
21. Feng H., et al. “A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT”. Japanese Journal of Radiology5 (2020): 409-410.
22. Advice on the use of point-of-care immunodiagnostic tests for COVID-19. Scientific Brief. World health organization (2020).
23. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) (2020).
24. Long C., et al. “Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?”. European Journal of Radiology 126 (2020): 108961.
25. Young D., et al. “Chest CT versus RT-PCR for Diagnostic Accuracy of COVID-19 Detection: A Meta-Analysis”. The Journal of Vascular Medicine and Surgery 8 (2020): 3.
26. Mandeep R Mehra MR., et al. “Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19 (2020).
27. Estimating mortality from COVID-19. Scientific Brief. World health organization (2020).

Citation

Citation: Afridi Sikandar Aziz. “Effects of COVID-19 on Living Donor Liver Transplantation”. Acta Scientific Gastrointestinal Disorders 4.6 (2021): 32-38.

Copyright

Copyright: © 2021 Afridi Sikandar Aziz. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.