Westchester Medical Center, Valhalla, NY, USA.
New York Medical College, Valhalla, NY, USA.
Transpl Infect Dis. 2021 Apr;23(2):e13492. doi: 10.1111/tid.13492. Epub 2020 Oct 22.
Transplantation in potential candidates who have recently recovered from COVID-19 is a challenge with uncertainties regarding the diagnosis, multi-organ systemic involvement, prolonged viral shedding in immunocompromised patients, and optimal immunosuppression. A 42 year male with alcoholic hepatitis underwent a successful deceased donor liver transplantation 71 days after the initial diagnosis of COVID-19. At the time of transplant, he was SARS-CoV-2 PCR negative for 24 days and had a MELD score of 33. His post-operative course was complicated by acute rejection which responded to intense immune-suppression using T-cell depletion and steroids. He was discharged with normal end-organ function and no evidence of any active infection including COVID-19. Prospective organ transplant recipients who have recovered from COVID-19 can be considered for transplantation after careful pre-transplant evaluation, donor selection, and individualized risk-benefit analysis.
对于最近从 COVID-19 中康复的潜在候选者进行移植是一项具有挑战性的工作,因为存在诊断、多器官系统受累、免疫功能低下患者病毒持续脱落以及最佳免疫抑制等方面的不确定性。一名 42 岁的酒精性肝炎男性在最初诊断 COVID-19 71 天后成功接受了已故供体的肝移植。在移植时,他的 SARS-CoV-2 PCR 检测结果为阴性 24 天,MELD 评分为 33。他的术后病程复杂,出现急性排斥反应,通过 T 细胞耗竭和类固醇进行强化免疫抑制治疗后得到缓解。他出院时,终末器官功能正常,没有任何活动性感染的证据,包括 COVID-19。对于已经从 COVID-19 中康复的潜在器官移植受者,在仔细的移植前评估、供者选择和个体化风险效益分析后,可以考虑进行移植。