Article (Scientific journals)
COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study.
Belli, Luca Saverio; Duvoux, Christophe; Cortesi, Paolo Angelo et al.
2021In Gut, 70 (10), p. 1914-1924
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Keywords :
COVID-19; liver cirrhosis; liver transplantation; organ transplantation; transplantation; liege
Abstract :
[en] OBJECTIVE: Explore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course. DESIGN: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed. RESULTS: From 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10-30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15-19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44-102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31-170). CONCLUSIONS: Increased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).
Disciplines :
Gastroenterology & hepatology
Surgery
Author, co-author :
Belli, Luca Saverio
Duvoux, Christophe
Cortesi, Paolo Angelo
Facchetti, Rita
Iacob, Speranta
Perricone, Giovanni
Radenne, Sylvie
Conti, Sara
Patrono, Damiano
Berlakovich, Gabriela
Hann, Angus
Pasulo, Luisa
Castells, Lluis
Faitot, Francois
Detry, Olivier  ;  Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne
Invernizzi, Federica
Magini, Giulia
De Simone, Paolo
Kounis, Ilias
Morelli, Maria Cristina
Díaz Fontenla, Fernando
Ericzon, Bo-Göran
Loinaz, Carmelo
Johnston, Chris
Gheorghe, Liliana
Lesurtel, Mickael
Romagnoli, Renato
Kollmann, Dagmar
Perera, M. Thamara Pr
Fagiuoli, Stefano
Mirza, Darius
Coilly, Audrey
Toso, Christian
Zieniewicz, Krzysztof
Elkrief, Laure
Karam, Vincent
Adam, Rene
den Hoed, Caroline
Merli, Marco
Puoti, Massimo
De Carlis, Luciano
Oniscu, Gabriel C.
Piano, Salvatore
Angeli, Paolo
Fondevila, Constantino
Polak, Wojciech G.
More authors (36 more) Less
Language :
English
Title :
COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study.
Publication date :
October 2021
Journal title :
Gut
ISSN :
0017-5749
eISSN :
1468-3288
Publisher :
BMJ Publishing Group, United Kingdom
Volume :
70
Issue :
10
Pages :
1914-1924
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Available on ORBi :
since 21 July 2021

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