Liver Unit, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
Department of Hepatobiliary Surgery and Transplant Unit, Tor Vergata University of Rome, Rome, Italy.
Transpl Infect Dis. 2021 Feb;23(1):e13417. doi: 10.1111/tid.13417. Epub 2020 Jul 31.
Liver transplant (LT) recipients are considered at a particularly high risk for developing critical COVID-19 infection. To date, available data are heterogeneous and scarce and mortality in LT recipients seems to be higher compared to normal population, but whether this is caused by altered immunological status, immunosuppression (IS), or underlying comorbidities has not yet been fully clarified. Some evidences show that IS might play a role in the pathophysiology of this new disease. We searched all available data regarding LT recipients infected by COVID-19, focusing on the role of IS. To date, 244 LT recipients have been reported as COVID-19-positive. Trends among transplant physicians are to reduce overall IS, especially antimetabolite drugs, but the current available observations are still not enough to build strong evidences for recommendation and IS should be meticulously tailored case by case.
肝移植（LT）受者被认为特别容易发生严重的 COVID-19 感染。迄今为止，可用的数据具有异质性且稀缺，LT 受者的死亡率似乎高于普通人群，但这是否是由免疫状态改变、免疫抑制（IS）或潜在合并症引起的尚未完全阐明。一些证据表明，IS 可能在这种新疾病的病理生理学中发挥作用。我们搜索了所有关于 COVID-19 感染的 LT 受者的可用数据，重点关注 IS 的作用。迄今为止，已有 244 名 LT 受者被报告为 COVID-19 阳性。移植医生的趋势是减少整体 IS，特别是抗代谢药物，但目前的观察结果还不足以为推荐提供强有力的证据，IS 应根据具体情况进行精心调整。
