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一名肝移植受者感染严重急性呼吸综合征冠状病毒 2 后结局良好。

The case of a liver-transplant recipient with severe acute respiratory syndrome coronavirus 2 infection who had a favorable outcome.

机构信息

Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, 1-3-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.

出版信息

Clin J Gastroenterol. 2021 Jun;14(3):842-845. doi: 10.1007/s12328-021-01374-x. Epub 2021 Mar 6.

Abstract

The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in 2019; thereafter, the COVID-19 outbreak became a health emergency of international concern. The impact of COVID-19 on liver-transplant recipients is unclear. Thus, it is currently unknown whether liver-transplant recipients are at a higher risk of developing complications related to COVID-19. Here, we report the case of liver-transplant recipients who were infected with SARS-CoV-2. A 20-year-old man who had undergone living-donor liver transplantation from his father at 5 years of age because of congenital biliary atresia was referred to our hospital for SARS-CoV-2 infection. Chest computed tomography did not show any abnormalities; however, laboratory results revealed liver dysfunction. He received tacrolimus as maintenance therapy that was continued at the same dose. He has not developed severe pulmonary disease and was discharged after 10 days of hospitalization. Limited data are available on post-transplant patients with COVID-19, and this case of a young patient without metabolic comorbidities did not show any association of severe COVID-19 under tacrolimus treatment. The progression of COVID-19 in liver-transplant recipients is complex, and COVID-19 risk should be evaluated in each patient until the establishment of optimal guidelines.

摘要

2019 年,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引发了 2019 年冠状病毒病(COVID-19)疫情爆发,此后,COVID-19 疫情成为国际关注的突发公共卫生事件。COVID-19 对肝移植受者的影响尚不清楚。因此,目前尚不清楚肝移植受者是否有更高的风险发生与 COVID-19 相关的并发症。在此,我们报告了一例感染 SARS-CoV-2 的肝移植受者。一名 20 岁男性,因先天性胆道闭锁于 5 岁时接受其父亲的活体供肝移植,因 SARS-CoV-2 感染转入我院。胸部计算机断层扫描未显示任何异常;然而,实验室结果显示肝功能异常。他接受了他克莫司作为维持治疗,剂量保持不变。他没有发展成严重的肺部疾病,住院 10 天后出院。关于 COVID-19 后移植患者的数据有限,并且该例无代谢合并症的年轻患者在他克莫司治疗下并未显示出与严重 COVID-19 有任何关联。肝移植受者 COVID-19 的进展较为复杂,在建立最佳指南之前,应在每位患者中评估 COVID-19 风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5f5/7936581/871e5e13b4bc/12328_2021_1374_Fig1_HTML.jpg

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