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肝病患者和肝移植受者中的新型冠状病毒肺炎:临床意义、预防与管理

COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management.

作者信息

Perreault Gabriel, Ching Charlotte, Nobel Yael R

机构信息

Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, NY, USA.

Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.

出版信息

Therap Adv Gastroenterol. 2023 Jul 25;16:17562848231188586. doi: 10.1177/17562848231188586. eCollection 2023.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has had enormous implications for the care of patients with chronic liver disease (CLD), cirrhosis, and liver transplant (LT). Clinical outcomes of COVID-19 vary in patients with CLD and cirrhosis compared to healthy controls, and in patients with LT compared to patients without LT. Several special considerations apply to the approach to vaccination and treatment in patients with CLD and LT. The practice of liver transplantation has also been heavily impacted by the pandemic, including persistent reductions in living donor LT and increases in LT for an indication of alcohol-related liver disease. Recent medical society guidelines strive to standardize severe acute respiratory syndrome coronavirus 2 testing in donors and recipients and the approach to transplantation after recovered from COVID-19 infection, but certain controversies remain.

摘要

2019年冠状病毒病(COVID-19)大流行对慢性肝病(CLD)、肝硬化和肝移植(LT)患者的护理产生了巨大影响。与健康对照相比,CLD和肝硬化患者的COVID-19临床结局有所不同;与未进行肝移植的患者相比,肝移植患者的COVID-19临床结局也有所不同。对于CLD和肝移植患者的疫苗接种和治疗方法,有几个特殊的注意事项。肝移植实践也受到了大流行的严重影响,包括活体供体肝移植持续减少以及因酒精性肝病指征而进行的肝移植增加。最近的医学协会指南努力规范供体和受体中严重急性呼吸综合征冠状病毒2检测以及COVID-19感染康复后的移植方法,但仍存在某些争议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d699/10375040/dd14028fff22/10.1177_17562848231188586-fig1.jpg

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