Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region.
Outbreak
SARS-CoV-2
Team working
Tertiary healthcare
Transplant activity
Journal
Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
13
06
2020
revised:
16
07
2020
accepted:
17
07
2020
pubmed:
30
8
2020
medline:
29
6
2021
entrez:
30
8
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic is an emergency worldwide. In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak. To analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity, comparing the number of LT in the first two months with the same period of time in 2019. We compared the liver transplants performed in our Center between February 24th and April 17th, 2020 with liver transplants performed in the same period in 2019. In 2020, 21 patients underwent liver transplantation from deceased donors, exactly as the year before, without statistically significant difference. All patients survived in both groups, and the rate of early graft dysfunction was 24% in 2020 and 33% in 2019. In 2020 Median MELD was higher (17 vs 13). We were able to perform 3 multiorgan transplants and one acute liver failure. Nobody died on waiting list. The performance of our Center, despite the maxi-emergency situation, was steady and this was the result of a tremendous team working within the hospital and in our region. Team working allowed our Center to maintain its activity level, taking care of patients before and after liver transplantation. Sharing our experience, we hope to be helpful to other Centers that are facing the pandemic and, if another pandemic comes, to be more prepared to deal with it.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 pandemic is an emergency worldwide. In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak.
AIMS
OBJECTIVE
To analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity, comparing the number of LT in the first two months with the same period of time in 2019.
METHODS
METHODS
We compared the liver transplants performed in our Center between February 24th and April 17th, 2020 with liver transplants performed in the same period in 2019.
RESULTS
RESULTS
In 2020, 21 patients underwent liver transplantation from deceased donors, exactly as the year before, without statistically significant difference. All patients survived in both groups, and the rate of early graft dysfunction was 24% in 2020 and 33% in 2019. In 2020 Median MELD was higher (17 vs 13). We were able to perform 3 multiorgan transplants and one acute liver failure. Nobody died on waiting list. The performance of our Center, despite the maxi-emergency situation, was steady and this was the result of a tremendous team working within the hospital and in our region.
CONCLUSIONS
CONCLUSIONS
Team working allowed our Center to maintain its activity level, taking care of patients before and after liver transplantation. Sharing our experience, we hope to be helpful to other Centers that are facing the pandemic and, if another pandemic comes, to be more prepared to deal with it.
Identifiants
pubmed: 32859555
pii: S2210-7401(20)30207-2
doi: 10.1016/j.clinre.2020.07.017
pmc: PMC7413117
pii:
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
101512Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.
Références
Euro Surveill. 2020 Jan;25(3):
pubmed: 31992387
Liver Transpl. 2010 Aug;16(8):943-9
pubmed: 20677285
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2131-2133.e1
pubmed: 32334081
Transpl Int. 2003 Jul;16(7):486-93
pubmed: 12669196
Am J Transplant. 2020 Jul;20(7):1780-1784
pubmed: 32243677
Liver Transpl. 2020 Jun;26(6):832-834
pubmed: 32196933
Liver Transpl. 2020 Aug;26(8):1052-1055
pubmed: 32369251
Liver Int. 2020 Jun;40(6):1278-1281
pubmed: 32251539
JHEP Rep. 2020 Jun;2(3):100113
pubmed: 32289115
Lancet Gastroenterol Hepatol. 2020 Jun;5(6):532-533
pubmed: 32278366
Lancet Gastroenterol Hepatol. 2020 Jun;5(6):528-529
pubmed: 32197093
Liver Transpl. 2020 Jul;26(7):941-944
pubmed: 32378325
Am J Transplant. 2020 Jul;20(7):1840-1848
pubmed: 32330351
Hepatology. 2020 Oct;72(4):1491-1493
pubmed: 32220017
Hepatology. 2020 Jul;72(1):287-304
pubmed: 32298473