Rammohan Ashwin
The Institute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Chennai 600044, India.
World J Transplant. 2020 Sep 18;10(9):267-276. doi: 10.5500/wjt.v10.i9.267.
The coronavirus pandemic (COVID-19) has had an unprecedented effect on various disease processes and their management. COVID-19 is likely to have a complex pathophysiological interplay with the post-transplant patients; one affecting the clinical course and outcome of the other. In the absence of validated data from trials, there is strong dependence on experience based on previous similar epidemics (SARS/MERS), and from consensus based on expert opinions. Despite the fact that our knowledge is rapidly evolving with time, there still is relatively limited objective data on the effect of COVID-19 on the human body. Numerous questions remain unanswered, one of which involves the management of immunosuppression in the post-transplant recipient during this contagion. The core tenet of which continues to be that of establishing an equipoise between infection and rejection. This review summarises the current knowledge on immune interactions of the virus, the immunomodulatory effects that may be at play, and its relation to the art of immunosuppression.
冠状病毒大流行（COVID-19）对各种疾病进程及其管理产生了前所未有的影响。COVID-19可能与移植后患者存在复杂的病理生理相互作用；一方会影响另一方的临床病程和结局。在缺乏来自试验的有效数据的情况下，很大程度上依赖基于以往类似疫情（SARS/MERS）的经验以及基于专家意见的共识。尽管我们的知识随着时间迅速发展，但关于COVID-19对人体影响的客观数据仍然相对有限。许多问题仍未得到解答，其中之一涉及在这种传染病流行期间移植后受者免疫抑制的管理。其核心原则仍然是在感染和排斥之间建立平衡。本综述总结了关于该病毒免疫相互作用、可能起作用的免疫调节效应及其与免疫抑制技术关系的当前知识。
