Bacterial and Viral Infections in Liver Transplantation: New Insights from Clinical and Surgical Perspectives DOI Creative Commons
Nour Shbaklo, Francesco Tandoi, Tommaso Lupia

et al.

Biomedicines, Journal Year: 2022, Volume and Issue: 10(7), P. 1561 - 1561

Published: June 30, 2022

End-stage liver disease patients undergoing transplantation are prone to develop numerous infectious complications because of immunosuppression, surgical interventions, and malnutrition. Infections in transplant recipients account for the main cause mortality morbidity with rates up 80%. The challenges faced early post-transplant period tend be linked procedures nosocomial infections commonly bloodstream, surgical, intra-abdominal sites. Viral represent an additional complication immunosuppression; they can donor-derived, reactivated from a latent virus, or community-acquired. Bacterial viral solid organ managed by prophylaxis, multi-drug resistant screening, risk assessment, vaccination, infection control antimicrobial stewardship. aim this review was discuss epidemiology bacterial transplants, issues, as well frontiers ex situ perfusion.

Language: Английский

The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic DOI Creative Commons
Ailish Nimmo, Dale Gardiner, Ines Ushiro‐Lumb

et al.

Transplantation, Journal Year: 2022, Volume and Issue: 106(7), P. 1312 - 1329

Published: April 11, 2022

The coronavirus disease 2019 (COVID-19) pandemic has had a major global impact on solid organ transplantation (SOT). An estimated 16% reduction in transplant activity occurred over the course of 2020, most markedly impacting kidney and living donor programs, resulting substantial knock-on effects for waitlisted patients. increased severe acute respiratory syndrome 2 (SARS-CoV-2) infection risk excess deaths candidates resulted effort to prioritize safe restart continuation programs second year pandemic, with rates returning towards prepandemic levels. Over past y, COVID-19 mortality SOT recipients fallen from 20%-25% 8%-10%, attributed early availability SARS-CoV-2 testing, adherence nonpharmaceutical interventions, development novel treatments, vaccination. Despite these positive steps, continue face challenges. Vaccine efficacy is substantially lower than general population remain at an adverse outcomes if they develop COVID-19. teams need vigilant ongoing interventions appears essential. In this review, we summarize activity, evaluation, patient discuss current strategies aimed preventing treating recipients, based lessons learnt propose steps community could consider as preparation future pandemics.

Language: Английский

Citations

81
COVID-19 and liver disease DOI
Jean‐François Dufour, Thomas Marjot, Chiara Becchetti

et al.

Gut, Journal Year: 2022, Volume and Issue: 71(11), P. 2350 - 2362

Published: June 14, 2022

Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review manifestations pathophysiological aspects related to patients without disease as well impact of with chronic (CLD), particularly cirrhosis transplantation (LT). been associated overt proinflammatory cytokine profile, which probably contributes substantially observed early late abnormalities. CLD, decompensated cirrhosis, should be regarded a risk factor for severe death. LT was impacted pandemic, mainly due concerns regarding donation recipients. However, did not represent per se worse outcome. Even though scarce, data specific therapy special populations such recipients seem promising. vaccine-induced immunity seems impaired CLD recipients, advocating revised schedule vaccine administration this population.

Language: Английский

Citations

71
International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates—2024 DOI
Yael Peled,

Anique Ducharme,

M. Kittleson

et al.

The Journal of Heart and Lung Transplantation, Journal Year: 2024, Volume and Issue: 43(10), P. 1529 - 1628.e54

Published: Aug. 8, 2024

Language: Английский

Citations

21
EASL Clinical Practice Guidelines on liver transplantation DOI
Eléonora De Martin, Thomas Berg, Didier Samuel

et al.

Journal of Hepatology, Journal Year: 2024, Volume and Issue: 81(6), P. 1040 - 1086

Published: Oct. 31, 2024

Language: Английский

Citations

17
Transplant of organs from donors with positive SARS‐CoV‐2 nucleic acid testing: A report from the organ procurement and transplantation network ad hoc disease transmission advisory committee DOI
Jason D. Goldman, Stephanie M. Pouch, Ann E. Woolley

et al.

Transplant Infectious Disease, Journal Year: 2023, Volume and Issue: 25(1)

Published: Jan. 24, 2023

Decisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test-positive (NAT+) donors must balance risk of donor-derived transmission events (DDTE) with the scarcity available organs.Organ Procurement and Transplantation Network (OPTN) data were used compare organ utilization recipient outcomes between SARS-CoV-2 NAT+ NAT- donors. was defined by either a positive upper or lower tract (LRT) sample within 21 days procurement. Potential DDTE adjudicated OPTN Disease Transmission Advisory Committee.From May 27, 2021 (date OTPN policy for required LRT testing lung donors) January 31, 2022, recovered 617 all regions 53 57 (93%) procurement organizations. younger had higher quality scores kidney liver. Organ compared A total 1241 (776 kidneys, 316 livers, 106 hearts, 22 lungs, other) transplanted 514 946 8853 Medical urgency recipients liver heart transplants. The median waitlist time longer match run sequence number final acceptor types. Outcomes hospital length stay, 30-day mortality, graft loss similar No occurred in this interval.Transplantation donor appears safe short-term death ameliorates shortage. Further study is assure comparable term outcomes.

Language: Английский

Citations

32
Utilization and outcomes of deceased donor SARS-CoV-2–positive organs for solid organ transplantation in the United States DOI
Jesse D. Schold, Christine Koval, Alvin Wee

et al.

American Journal of Transplantation, Journal Year: 2022, Volume and Issue: 22(9), P. 2217 - 2227

Published: June 22, 2022

Language: Английский

Citations

37
Immuno-Thrombotic Complications of COVID-19: Implications for Timing of Surgery and Anticoagulation DOI Creative Commons
Connor M. Bunch, Ernest E. Moore, Hunter B. Moore

et al.

Frontiers in Surgery, Journal Year: 2022, Volume and Issue: 9

Published: May 4, 2022

Early in the coronavirus disease 2019 (COVID-19) pandemic, global governing bodies prioritized transmissibility-based precautions and hospital capacity as foundation for delay of elective procedures. As surgical volumes increased, convalescent COVID-19 patients faced increased postoperative morbidity mortality clinicians had limited evidence stratifying individual risk this population. Clear now demonstrates that those recovering from have mortality. These data—in conjunction with recent American Society Anesthesiologists guidelines—offer necessary to expand early pandemic guidelines guide surgeon’s preoperative assessment. Here, we argue surgeries should still be delayed on a personalized basis maximize outcomes. We outline framework patient’s fitness surgery based symptoms severity acute or illness, coagulopathy assessment, acuity procedure. Although most common manifestation severe respiratory syndrome 2 (SARS-CoV-2) infection is pneumonitis, every system body potentially afflicted by an endotheliitis. This endothelial derangement often manifests hypercoagulable state admission associated occult symptomatic venous arterial thromboembolisms. The delicate balance between hyper hypocoagulable states defined local immune-thrombotic crosstalk results commonly hemostatic known fibrinolytic shutdown. In tandem, derangements occur during affect not only timing procedures, but also incidence complications related COVID-19-associated (CAC). Traditional methods thromboprophylaxis treatment thromboses after require tailored approach guided understanding pathophysiologic underpinnings patient. Likewise, prolonged period developing following hospitalization due has resulted differing societies recommend varying periods SARS-CoV-2 infection. conclusion, propose perioperative, assessment patients’ CAC using viscoelastic assays fluorescent microclot analysis.

Language: Английский

Citations

36
Organ transplantation using COVID-19-positive deceased donors DOI
M.J. Bock, Gabrielle Vaughn, Peter Chau

et al.

American Journal of Transplantation, Journal Year: 2022, Volume and Issue: 22(9), P. 2203 - 2216

Published: July 13, 2022

Language: Английский

Citations

36
Solid organ transplantation from COVID positive donors in the United States: Analysis of United Network for Organ Sharing database DOI
Abhay Dhand, Kenji Okumura, Christopher Nabors

et al.

Transplant Infectious Disease, Journal Year: 2022, Volume and Issue: 25(1)

Published: Aug. 9, 2022

Abstract Background Significant uncertainties remain regarding the utilization of organs for solid organ transplantation (SOT) from donors with coronavirus disease 2019 (COVID‐19). The aim this study was to assess trends in COVID‐19 and their short‐term outcomes. Methods Deceased between March 2020 December 2021 a positive COVID nucleic acid test respiratory tract within 14 days were analyzed using de‐identified United Network Organ Sharing (UNOS) database. Donor recipient characteristics (COVID+) compared negative (COVID−) during period. We SOT COVID+ across States, donor characteristics, quality outcomes (length hospitalization, rates rejection, delayed graft function, 30‐day graft/patient survival). Results During period, 193 led 281‐kidneys, 106‐livers, 36‐hearts 414 adult recipients. patients donated median two organs. These younger had lower Kidney Profile Index (0.37 vs. 0.50, p < .001), serum creatinine (0.8 1.0 mg/dl, = .003), similar total bilirubin (0.6 .46), left ventricular ejection fraction (60%, .84) when COVID− donors. Short‐term outcomes, including survival, both groups. Conclusions Analysis UNOS database indicates that an otherwise medically suitable should not preclude consideration non‐lung transplantation. image

Language: Английский

Citations

28
Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: A systematic review DOI
Raquel Martínez-Reviejo, Sofía Tejada, Ana Cipriano

et al.

Anaesthesia Critical Care & Pain Medicine, Journal Year: 2022, Volume and Issue: 41(4), P. 101098 - 101098

Published: May 6, 2022

Language: Английский

Citations

26