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Carrying on with liver transplantation during the COVID-19 emergency: Report from piedmont region - 14/05/21

Doi : 10.1016/j.clinre.2020.07.017 
Margherita Saracco a, 1, Silvia Martini a, , 1 , Francesco Tandoi b, Dominic Dell’Olio c, Antonio Ottobrelli a, Antonio Scarmozzino d, Antonio Amoroso c, Paolo Fonio e, Roberto Balagna f, Renato Romagnoli b
a Gastrohepatology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy 
b General Surgery 2U, Liver Transplantation Center, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy 
c Regional Transplantation Center, Piedmont, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy 
d Molinette Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy 
e Radiology Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy 
f Anesthesia and Intensive Care Unit 2, AOU Città della Salute e della Scienza di Torino, Turin, Italy 

Correspondence author.

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Highlights

The COVID-19 pandemic is a public health emergency affecting all aspects of medical care, included liver transplant activity.
We aimed to analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity.
We compared the number of LT in the first two months with the same period of time in 2019, in our high-volume transplant Center (median 150 L T/year).
Team working with close involvement of several specialties allowed our single regional Center to maintain its activity level, taking care of patients before and after LT.
We think that LT, being a life-saving procedure, should be not suspended when it is possible. Sharing our experience, we hope to be helpful to other Transplant Centers that are now facing the COVID-19 emergency.

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Summary

Background

The COVID-19 pandemic is an emergency worldwide. In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak.

Aims

To analyze if our strategy and organization of LT pathway during the first two months of the COVID-19 emergency succeeded in keeping a high level of LT activity, comparing the number of LT in the first two months with the same period of time in 2019.

Methods

We compared the liver transplants performed in our Center between February 24th and April 17th, 2020 with liver transplants performed in the same period in 2019.

Results

In 2020, 21 patients underwent liver transplantation from deceased donors, exactly as the year before, without statistically significant difference. All patients survived in both groups, and the rate of early graft dysfunction was 24% in 2020 and 33% in 2019. In 2020 Median MELD was higher (17 vs 13). We were able to perform 3 multiorgan transplants and one acute liver failure. Nobody died on waiting list. The performance of our Center, despite the maxi-emergency situation, was steady and this was the result of a tremendous team working within the hospital and in our region.

Conclusions

Team working allowed our Center to maintain its activity level, taking care of patients before and after liver transplantation. Sharing our experience, we hope to be helpful to other Centers that are facing the pandemic and, if another pandemic comes, to be more prepared to deal with it.

Le texte complet de cet article est disponible en PDF.

Abbreviations : AIH, ALF, ASSLD, BAL, CIT, CNT, EAD, EASL, HCC, HOPE, ICU, LT, MELD, NASH, NPS, WHO

Keywords : SARS-CoV-2, Outbreak, Transplant activity, Tertiary healthcare, Team working


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Vol 45 - N° 3

Article 101512- mai 2021 Retour au numéro
Article précédent Article précédent
  • Long-term results of pediatric liver transplantation for autoimmune liver disease
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