Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.
Hepatology and Liver Transplantation A. C. Camargo Cancer Center, São Paulo, Brazil.
Pediatr Transplant. 2021 Dec;25(8):e14112. doi: 10.1111/petr.14112. Epub 2021 Aug 16.
The impact of the COVID pandemic on liver transplant (LT) programs varied among countries. Few data are available about that impact in pediatric liver transplant (PLT) programs. This study aimed at comparing the data of our program in Brazil (2019 vs. 2020).
Retrospective cohort study.
One hundred and seventy-four PLT were performed in the period (93% living donors). Patients were divided into two groups according to the LT date: pre-COVID-19 period (march/2019-February/2020) and COVID-19 period (March/2020-February 2021). In the pre-COVID-19 period, 97 LTs were performed, and 77 LTs were performed in the COVID-19 period. Patients in the COVID-19 period were younger (10.9 months vs. 16 months, p 0.009), had higher PELD scores (15 vs. 14, p 0.04), more ascites (66.2 vs. 51.5%, p 0.03), and more frequently hospitalized before LT (27.3 vs. 17.5%). However, there was no difference in post-LT complications, retransplantation nor survival rates. Six (6.2%) patients from pre-COVID-19 period were COVID positive at a median of 15.5 months (14-17.5), and 6 (7.8%) patients from COVID-19 period were COVID positive at a median of 3 months (20 days-6 months) from LT. There was neither mortality nor complications in those patients. Four (33%) were hospitalized, and one had prolonged intubation. Four (33%) were asymptomatic, 4 (33%) had upper airways symptoms, and the remaining had gastrointestinal symptoms.
Overall, PLT was not affected during COVID-19 period. Even though patients from COVID-19 period were sicker, there was no significant impact in LT outcomes. All the recipients who tested positive for COVID had a favorable outcome.
COVID 大流行对各国的肝移植（LT）项目产生了不同的影响。关于儿科肝移植（PLT）项目的影响，数据很少。本研究旨在比较我们在巴西的项目数据（2019 年与 2020 年）。
回顾性队列研究。
在此期间进行了 174 例 PLT（93%为活体供者）。根据 LT 日期将患者分为两组：COVID-19 前（2019 年 3 月至 2020 年 2 月）和 COVID-19 期间（2020 年 3 月至 2021 年 2 月）。在 COVID-19 前，进行了 97 例 LT，而在 COVID-19 期间进行了 77 例 LT。COVID-19 期间的患者年龄更小（10.9 个月与 16 个月，p=0.009），PELD 评分更高（15 与 14，p=0.04），腹水更多（66.2%与 51.5%，p=0.03），并且在 LT 前更频繁地住院（27.3%与 17.5%）。然而，两组之间的 LT 后并发症、再次移植或生存率没有差异。COVID-19 前的 6 例（6.2%）患者在中位 15.5 个月（14-17.5）时 COVID 呈阳性，COVID-19 期间的 6 例（7.8%）患者在 LT 后中位 3 个月（20 天至 6 个月）时 COVID 呈阳性。这些患者均无死亡或并发症。4 例（33%）住院，1 例需要延长插管。4 例（33%）无症状，4 例（33%）上呼吸道症状，其余有胃肠道症状。
总体而言，COVID-19 期间 PLT 未受影响。尽管 COVID-19 期间的患者病情更严重，但 LT 结果并无显著影响。所有 COVID 检测呈阳性的受者结局均良好。
