Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Liver Transplant Unit, Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
Transpl Int. 2020 Oct;33(10):1244-1252. doi: 10.1111/tri.13680. Epub 2020 Aug 13.
There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR). One hundred nine out of 149 (73%) of ELTR centers located in 28 European countries (93%) responded. Ninety-four (86%) of the centers tested all donors, and 75 (69%) centers tested all LT recipients for SARS-CoV-2. Seventy-three (67%) centers selected recipients for LT in the COVID-19 pandemic, whereas 33% did not. Eighty-eight centers reported COVID-19 infection in 57 LT candidates and in 272 LT recipients. Overall crude incidence of COVID-19 among LT candidates and recipients was estimated 1.05% (range 0.5-20%) and 0.34% (range 0.1-4.8%), respectively, and it was significantly higher among candidates (P < 0.001). Crude rate of death was 18% (10/57) among candidates and 15% (36/244) among recipients. This first large-scale European snapshot study clearly shows that both LT candidates and recipients are at a high risk for COVID-19. These results plead for an early and pro-active screening of COVID-19 symptoms in these populations.
关于 COVID-19 大流行对欧洲肝移植 (LT) 的影响，相关数据非常有限。本研究旨在初步了解欧洲肝移植受者和候选者中 COVID-19 的发病率、管理和转归。我们采用基于互联网的调查方式，向欧洲肝移植注册中心 (ELTR) 的附属中心发送了问卷。ELTR 分布在欧洲 28 个国家的 149 个中心中，有 109 个（73%）中心做出了回应，其中 94 个（86%）中心对所有供者进行了检测，75 个（69%）中心对所有 LT 受者进行了 SARS-CoV-2 检测。73 个（67%）中心在 COVID-19 大流行期间选择了 LT 受者，而 33%的中心没有。88 个中心报告了 57 例 LT 候选者和 272 例 LT 受者的 COVID-19 感染。LT 候选者和受者中 COVID-19 的总体粗发病率估计分别为 1.05%（范围 0.5-20%）和 0.34%（范围 0.1-4.8%），且候选者的发病率明显更高（P<0.001）。候选者的死亡率为 18%（10/57），受者的死亡率为 15%（36/244）。这是首次对欧洲进行的大规模快照研究，清楚地表明 LT 候选者和受者均面临 COVID-19 的高风险。这些结果表明，应对这些人群进行 COVID-19 症状的早期和积极筛查。
