Liver transplant immunosuppression during the covid-19 pandemic.
Inmunosupresión en el trasplante hepático en la era covid-19.
Adaptive Immunity
Antiviral Agents
/ pharmacology
Betacoronavirus
/ immunology
COVID-19
Calcineurin Inhibitors
/ adverse effects
Contraindications, Drug
Coronavirus Infections
/ drug therapy
Disease Susceptibility
Drug Interactions
Everolimus
/ adverse effects
Glucocorticoids
/ adverse effects
Humans
Immunity, Innate
Immunocompromised Host
Immunosuppression Therapy
/ adverse effects
Immunosuppressive Agents
/ adverse effects
Liver Transplantation
Mycophenolic Acid
/ adverse effects
Pandemics
Pneumonia, Viral
/ epidemiology
Postoperative Complications
/ immunology
SARS-CoV-2
Sirolimus
/ adverse effects
TOR Serine-Threonine Kinases
/ antagonists & inhibitors
COVID-19 Drug Treatment
Citoquinas
Cytokines
Immunomodulation
Immunosuppression
Inmunomoduladores
Inmunosupresión
Liver transplant
Neumonía
Pneumonia
SARS-CoV-2
Trasplante hepático
Journal
Gastroenterologia y hepatologia
ISSN: 0210-5705
Titre abrégé: Gastroenterol Hepatol
Pays: Spain
ID NLM: 8406671
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
13
05
2020
revised:
27
05
2020
accepted:
07
06
2020
pubmed:
11
7
2020
medline:
21
10
2020
entrez:
11
7
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 32646657
pii: S0210-5705(20)30215-6
doi: 10.1016/j.gastrohep.2020.06.003
pmc: PMC7290227
pii:
doi:
Substances chimiques
Antiviral Agents
0
Calcineurin Inhibitors
0
Glucocorticoids
0
Immunosuppressive Agents
0
Everolimus
9HW64Q8G6G
MTOR protein, human
EC 2.7.1.1
TOR Serine-Threonine Kinases
EC 2.7.11.1
Mycophenolic Acid
HU9DX48N0T
Sirolimus
W36ZG6FT64
Types de publication
Journal Article
Review
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
457-463Informations de copyright
Copyright © 2020 Elsevier España, S.L.U. All rights reserved.
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