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肝移植后立即发生新型冠状病毒肺炎1例:并非全是坏消息。

A case of COVID-19 immediately after liver transplantation: Not only bad news.

作者信息

Prieto Mikel, Gastaca Mikel, Ruiz Patricia, Ventoso Alberto, Palomares Ibone, Rodríguez-Álvarez Regino José, Salvador Patricia, Bustamante Javier, Valdivieso Andrés

机构信息

Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Bilbao, Spain.

Medicine Faculty, University of the Basque Country, Bilbao, Spain.

出版信息

Ann Hepatobiliary Pancreat Surg. 2020 Aug 31;24(3):314-318. doi: 10.14701/ahbps.2020.24.3.314.

Abstract

COVID-19, the illness caused by the SARS-CoV-2 virus originated in December 2019 in Wuhan, China and has caused more 3,3 million cases and more than 230,000 deaths throughout the world, with 25,000 of them only in Spain, where the first case was diagnosed on January 31st, 2020. As COVID-19 is a "new" disease, we still do not have data on prognosis or treatment in transplant patients or on how to manage immunosuppression in this complex scenario. We present a case of COVID-19 diagnosed during the early postoperative period in a recipient whose liver transplantation was performed on late March during the lockdown in Spain, with donor and recipient previously negative rRT-PCR to SARS-CoV-2. In the first post-operative week the patient suffered COVID-19 pneumonia that was treated with immunosuppression minimization, oral Hydroxycloroquine and Azithromycin with favorable outcome. The patient was discharged on POD 21 without complications. To date, few early post-liver transplantation SARS-CoV-2 infected recipients have been published, but only one was an early postoperative infection. In our case the outcome was favorable, even though it was an early post -liver transplantation COVID-19 in a frail patient.

摘要

2019年12月起源于中国武汉的新型冠状病毒肺炎(COVID-19),由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,已在全球造成超过330万例病例和超过23万例死亡,仅在西班牙就有2.5万例,该国于2020年1月31日确诊首例病例。由于COVID-19是一种“新型”疾病,我们仍然没有关于移植患者预后或治疗的数据,也没有关于在这种复杂情况下如何管理免疫抑制的数据。我们报告一例在西班牙封锁期间3月下旬接受肝移植的受者术后早期被诊断为COVID-19的病例,供体和受体之前的逆转录-聚合酶链反应(rRT-PCR)检测结果均为SARS-CoV-2阴性。术后第一周,患者发生COVID-19肺炎,通过最小化免疫抑制、口服羟氯喹和阿奇霉素进行治疗,结果良好。患者在术后第21天出院,无并发症。迄今为止,很少有肝移植术后早期感染SARS-CoV-2的受者的报道,且仅有一例是术后早期感染。在我们的病例中,尽管患者身体虚弱且为肝移植术后早期COVID-19感染,但结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/206e/7452801/96ea5bc5e8ef/AHBPS-24-314-f1.jpg

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