There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR). One hundred nine out of 149 (73%) of ELTR centers located in 28 European countries (93%) responded. Ninety-four (86%) of the centers tested all donors, and 75 (69%) centers tested all LT recipients for SARS-CoV-2. Seventy-three (67%) centers selected recipients for LT in the COVID-19 pandemic, whereas 33% did not. Eighty-eight centers reported COVID-19 infection in 57 LT candidates and in 272 LT recipients. Overall crude incidence of COVID-19 among LT candidates and recipients was estimated 1.05% (range 0.5-20%) and 0.34% (range 0.1-4.8%), respectively, and it was significantly higher among candidates (P < 0.001). Crude rate of death was 18% (10/57) among candidates and 15% (36/244) among recipients. This first large-scale European snapshot study clearly shows that both LT candidates and recipients are at a high risk for COVID-19. These results plead for an early and pro-active screening of COVID-19 symptoms in these populations.

Department of Clinical Medicine and Surgery Federico 2 University Naples Italy

Department of European Liver Transplant Registry Centre Hépatobiliaire Hôpital Universitaire Paul Brousse Villejuif France

Department of General Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland

Department of General Visceral and Transplant Surgery Tuebingen University Hospital Tuebingen Germany

Department of Hepatobiliary Surgery Cancer and Transplantation AP HP Hôpital Universitaire Paul Brousse Villejuif France

Department of Hepatogastroenterology Institute for Clinical and Experimental Medicine Prague Czech Republic

Division of Abdominal Surgery Department of Surgery Geneva University Hospitals Geneva Switzerland

Division of Hepatology and Gastroenterology ASST Grande Ospedale Metropolitano Niguarda Milan Italy

Division of HPB and Transplant Surgery Department of Surgery Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands

Division of Paediatric Gastroenterology and Hepatology Department of Paediatric Kidney Liver and Metabolic Diseases Hannover Medical School Hannover Germany

Institute of Immunology and Immunotherapy University of Birmingham Birmingham UK

Liver Transplant Unit Department of General and Digestive Surgery Hospital Clinic IDIBAPS CIBERehd University of Barcelona Barcelona Spain

Medical Liver Transplant Unit and Liver Department Henri Mondor Hospital AP HP Paris Est University Créteil France

Multivisceral Transplant Unit Department of Surgery Oncology and Gastroenterology Padua University Hospital Padua Italy

Transpl Int. 2020 Dec;33(12):1823-1824. doi: 10.1111/tri.13729. PubMed

Transpl Int. 2020 Dec;33(12):1830-1832. doi: 10.1111/tri.13742. PubMed

Transpl Int. 2020 Dec;33(12):1825-1826. doi: 10.1111/tri.13765. PubMed

Zobrazit více v PubMed

Lescure FX, Bouadma L, Nguyen D, et al. Clinical and virological data of the first cases of COVID‐19 in Europe: a case series. Lancet Infect Dis 2020; 20: 697. PubMed PMC

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID‐19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054. PubMed PMC

http://www.euro.who.int/en/health‐topics/health‐emergencies/coronavirus‐covid‐19/news/news/2020/3/who‐announces‐covid‐19‐outbreak‐a‐pandemic.

Akalin E, Azzi Y, Bartash R, et al. Covid‐19 and kidney transplantation. N Engl J Med 2020; 382: 2475. PubMed PMC

Fernández‐Ruiz M, Andrés A, Loinaz C, et al. COVID‐19 in solid organ transplant recipients: a single‐center case series from Spain. Am J Transplant 2020; 20: 1849. PubMed PMC

Aigner C, Dittmer U, Kamler M, Collaud S, Taube C. COVID‐19 in a lung transplant recipient. J Heart Lung Transplant 2020; 39: 610. PubMed PMC

Mehta P, McAuley DF, Brown M, et al. COVID‐19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395: 1033. PubMed PMC

Guillen E, Pineiro GJ, Revuelta I, et al. Case report of COVID‐19 in a kidney transplant recipient: does immunosuppression alter the clinical presentation? Am J Transplant 2020; 20: 1875. PubMed PMC

Bhoori S, Rossi RE, Citterio D, Mazzaferro V. long‐term liver transplant patients: preliminary experience from an Italian transplant centre in Lombardy. Lancet Gastroenterol Hepatol 2020; 5: 532. PubMed PMC

www.gisaid.org.

worldpopulationreview.com.

https://edu.esottransplantlive.org.

Domínguez‐Gil B, Coll E, Fernández‐Ruiz M, et al. COVID‐19 in Spain: transplantation in the midst of the pandemic. Am J Transplant 2020. 10.1111/ajt.15983. Online ahead of print PubMed DOI PMC

Angelico R, Trapani S, Manzia TM, Lombardini L, Tisone G, Cardillo M. The COVID‐19 outbreak in Italy: initial implications for organ transplantation programs. Am J Transplant 2020; 20: 1780. PubMed PMC

Adam R, Karam V, Cailliez V, et al. Annual report of the European Liver Transplant Registry (ELTR) – 50‐year evolution of liver transplantation. Transpl Int 2018; 31: 1293. PubMed

Fix OK, Hameed B, Fontana RJ, et al. Clinical best practice advice for hepatology and liver transplant providers during the COVID‐19 pandemic: AASLD expert panel consensus statement. Hepatology 2020; 72: 287. 10.1002/hep.31281. PubMed DOI PMC

Ritschl PV, Nevermann N, Wiering L, et al. Solid organ transplantation programs facing lack of empiric evidence in the COVID‐19 pandemic: a by‐proxy society recommendation consensus approach. Am J Transplant 2020; 20: 1826. PubMed PMC

Maggi U, De Carlis L, Yiu D, et al. The impact of the COVID‐19 outbreak on liver transplantation programmes in Northern Italy. Am J Transplant 2020). 20, 1840. 10.1111/ajt.15948. PubMed DOI PMC

Lauterio A, De Carlis R, Belli L, Fumagalli R, De Carlis L. How to guarantee liver transplantation in the north of Italy during the COVID‐19 pandemic. A sound transplant protection strategy. Transpl Int 2020). 33, 969. 10.1111/tri.13633. PubMed DOI

Challenging management of severe chronic disorders in acute pandemic situation: Chronic liver disease under COVID-19 pandemic as the proof-of-principle model to orchestrate the measures in 3PM context