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

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