Single-center Outcomes After Liver Transplantation With SARS-CoV-2-Positive Donors: An Argument for Increased Utilization.

Autor:	Connor AA; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Adelman MW; Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX.; Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX.; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, HMH, Houston TX.; Department of Medicine, Weill Cornell Medical College, New York, NY., Mobley CM; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Moaddab M; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Pharmacy, Houston Methodist Hospital, Houston, TX., Erhardt AJ; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX., Hsu DE; Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, TX., Brombosz EW; Department of Surgery, Houston Methodist Hospital, Houston, TX., Sanghvi M; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX., Cheah YL; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX., Simon CJ; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX., Hobeika MJ; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Saharia AS; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Victor DW 3rd; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX., Kodali S; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX., Basra T; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX., Graviss EA; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX., Nguyen DT; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.; Department of Pediatrics, Baylor College of Medicine, Houston, TX., Elsaiey A; Department of Surgery, Houston Methodist Hospital, Houston, TX., Moore LW; Department of Surgery, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Nigo M; Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX.; Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY., Drews AL; Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX.; Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY., Grimes KA; Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX.; Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY., Arias CA; Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX.; Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX.; Department of Medicine, Weill Cornell Medical College, New York, NY., Li XC; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY.; Immunobiology and Transplant Science Center, Houston Methodist Hospital, Houston, TX., Gaber AO; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY., Ghobrial RM; Department of Surgery, Houston Methodist Hospital, Houston, TX.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Weill Cornell Medical College, New York, NY.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2024 Mar 07; Vol. 10 (4), pp. e1590. Date of Electronic Publication: 2024 Mar 07 (Print Publication: 2024).
DOI:	10.1097/TXD.0000000000001590
Abstrakt:	Background: The COVID-19 pandemic has led to an increase in SARS-CoV-2-test positive potential organ donors. The benefits of life-saving liver transplantation (LT) must be balanced against the potential risk of donor-derived viral transmission. Although emerging evidence suggests that the use of COVID-19-positive donor organs may be safe, granular series thoroughly evaluating safety are still needed. Results of 29 consecutive LTs from COVID-19-positive donors at a single center are presented here. Methods: A retrospective cohort study of LT recipients between April 2020 and December 2022 was conducted. Differences between recipients of COVID-19-positive (n = 29 total; 25 index, 4 redo) and COVID-19-negative (n = 472 total; 454 index, 18 redo) deceased donor liver grafts were compared. Results: COVID-19-positive donors were significantly younger ( P  = 0.04) and had lower kidney donor profile indices ( P  = 0.04) than COVID-19-negative donors. Recipients of COVID-19-positive donor grafts were older ( P  = 0.04) but otherwise similar to recipients of negative donors. Donor SARS-CoV-2 infection status was not associated with a overall survival of recipients (hazard ratio, 1.11; 95% confidence interval, 0.24-5.04; P  = 0.89). There were 3 deaths among recipients of liver grafts from COVID-19-positive donors. No death seemed virally mediated because there was no qualitative association with peri-LT antispike antibody titers, post-LT prophylaxis, or SARS-CoV-2 variants. Conclusions: The utilization of liver grafts from COVID-19-positive donors was not associated with a decreased overall survival of recipients. There was no suggestion of viral transmission from donor to recipient. The results from this large single-center study suggest that COVID-19-positive donors may be used safely to expand the deceased donor pool. Competing Interests: R.M.G. is a member of the advisory board for TransMedics and has received stock in the company. (Copyright © 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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