Abstract
BackgroundSolid organ transplantation (SOT) service has been disrupted during the current coronavirus disease 2019 (COVID-19) pandemic, which deferred the service in most centers worldwide. As the pandemic persists, there will be an urgency to identify the best and safest practices for resuming activities as areas re-open. Resuming activity is a difficult issue, in particular, the decision of reopening after a period of slowing down or complete cessation of activities.ObjectivesTo share our experience in resuming living donor liver transplantation (LDLT) in the context of the COVID-19 pandemic in the Liver Transplantation Unit of El-Manial Specialized Hospital, Cairo University, Egypt, and to review the obstacles that we have faced.Material and methodsThis study is a single-center study. We resumed LDLT by the 26th of August 2020 after a period of closure from the 1st of March 2020. We have taken a lot of steps in order to prevent COVID-19 transmission among transplant patients and healthcare workers (HCWs).ResultsIn our study, we reported three LDLT recipients, once resuming the transplantation till now. All our recipients and donors tested negative for SARS-CoV-2 by nasopharyngeal RT-PCR a day before the transplantation. Unfortunately, one of them developed COVID-19 infection. We managed rapidly to isolate him in a single room, restricting one team of HCWs to deal with him with strict personal protective measures. Finally, the patient improved and was discharged in a good condition. The second patient ran a smooth course apart from FK neurotoxicity which improved with proper management. The third patient experienced a sharp rise in bilirubin and transaminases on day 14 that was attributed to drug toxicity vs. rejection and managed by discontinuing the offending drugs and pulse steroids. In addition, one of our head nurses tested positive for SARS-CoV-2 that was manageable with self-isolation.ConclusionCareful patient, donor, personnel screening is mandatory. Adequate supply of personal protective equipments, effective infection control policies, and appropriate administrative modifications are needed for a safe return of LDLT practice.
Highlights
Since December 2019, the whole world suffers from a novel coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that was declared by the World Health Organization (WHO) as a global pandemic on March 11, 2020; since the entire health care environment, especially liver transplant (LT) services, has been affected worldwide [1].Solid organ transplantation (SOT) is facing many challenges that have been created during the COVID19 pandemic
All our recipients and donors tested negative for SARS-CoV-2 by nasopharyngeal Reverse transcription-polymerase chain reaction (RT-PCR) a day before the transplantation
Adequate supply of personal protective equipments, effective infection control policies, and appropriate administrative modifications are needed for a safe return of living donor liver transplantation (LDLT) practice
Summary
Since December 2019, the whole world suffers from a novel coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that was declared by the World Health Organization (WHO) as a global pandemic on March 11, 2020; since the entire health care environment, especially liver transplant (LT) services, has been affected worldwide [1]. Solid organ transplantation (SOT) is facing many challenges that have been created during the COVID19 pandemic. The limitation of data and the highly dynamic COVID-19 pandemic makes a high challenge to weigh the risks and benefits of resuming the SOT amidst fluctuating SARS-CoV-2 community transmission [3]. Solid organ transplantation (SOT) service has been disrupted during the current coronavirus disease 2019 (COVID-19) pandemic, which deferred the service in most centers worldwide. Resuming activity is a difficult issue, in particular, the decision of reopening after a period of slowing down or complete cessation of activities
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