Although a liver transplant requires subsequent immunosuppressant therapy, this not appear to increase patients’ susceptibility to mortality when hospitalised due to COVID-19.
This is the conclusion of a new analysis by an international team of researchers, of data contained in two liver transplant disease registries, COVID-Hep (based in the UK) and SECURE-Cirrhosis (based in the US).
For the study, the team collected information on 151 recipients from 18 countries, with a median age of 60 years (32% women) and compared the outcomes with a control group of 627 (median age 73 years, 48% women) patients. The major outcome of interest was death although the researchers also examined rates of intensive care admission. A similar number of patients were hospitalised (82% vs 76%) although a higher proportion of liver patients were admitted to intensive care (28% vs 8%, p < 0.0001) and given intensive ventilation (20% vs 5%, p < 0.0001). However, the proportion of patients dying was lower in the transplant group (19% vs 27%, p = 0.046) and none of the deaths were liver-related. Further analysis revealed that age, serum creatinine levels and cancer were associated with an increased risk of death among transplant patients.
The authors concluded factors such as age and co-morbidities were more important predictors of mortality than transplantation.
Webb GJ et al. Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study. Lancet Gastroenterol Hepatol 2020; August 28: https://doi.org/10.1016/ S2468-1253(20)30271-5