Jamir Imtiakum, Lohia Pankaj, Pande Rajesh Kumar, Setia Rasika, Singhal Amit Kumar, Chaudhary Abhideep
Department of HPB Surgery and Liver Transplantation, B. L. Kapoor Super Speciality Hospital, New Delhi, India.
Department of Critical Care, B. L. Kapoor Super Speciality Hospital, New Delhi, India.
Ann Hepatobiliary Pancreat Surg. 2020 Nov 30;24(4):526-532. doi: 10.14701/ahbps.2020.24.4.526.
The impact and clinical spectrum of COVID-19 infection in liver transplant recipients/solid organ transplants are being unveiled during this recent pandemic. The clinical experience of use of current antiviral drugs and immunomodulators are sparse in solid organ transplantation. We present the clinical course of a 49-year-old male recipient who underwent living donor liver transplant for recurrent gastrointestinal bleed and contracted severe COVID-19 pneumonia during the third postoperative week. Herein we report the successful management of severe COVID-19 pneumonia using convalescent plasma therapy and remdesivir. Recipient's clinical deterioration was halted after three consecutive convalescent plasma transfusions with improvement in hypoxia and inflammatory markers (interleukin-6 and C-reactive protein). The use of convalescent plasma therapy along with remdesivir may be an ideal combination in the management of severe COVID-19 pneumonia in solid organ transplant recipients.
在最近这场大流行期间,新型冠状病毒肺炎(COVID-19)感染对肝移植受者/实体器官移植受者的影响及临床谱正在逐渐明晰。在实体器官移植中,关于使用当前抗病毒药物和免疫调节剂的临床经验较少。我们介绍了一名49岁男性受者的临床病程,该受者因复发性胃肠道出血接受了活体供肝移植,并在术后第三周感染了重症COVID-19肺炎。在此,我们报告了使用康复期血浆疗法和瑞德西韦成功治疗重症COVID-19肺炎的情况。在连续三次输注康复期血浆后,受者的临床病情恶化得到遏制,缺氧及炎症标志物(白细胞介素-6和C反应蛋白)有所改善。在实体器官移植受者的重症COVID-19肺炎管理中,康复期血浆疗法与瑞德西韦联合使用可能是一种理想的组合。