Restarting LDLT During COVID-19: Early Results After Restructuring

• DOI: 10.1016/j.transproceed.2020.10.049
• Publication Date: 2020-12-16T22:15:59Z
• Authors: Sandeep K. Jha; Imtiakum Jamir; Kshitij Sisodia; Niteen Kumar; Gaurav Sood; Nitin Shanker; Sachin Anand; Gaurav Dubey; Vinod Choudhary; Pankaj Lohia; Amit Singhal; Manav Wadhawan; Ajay Kumar; Abhideep Chaudhary
• Keywords: Adult; Immunosuppression Therapy; Male; Transplantation; Infection Control; SARS-CoV-2; COVID-19; Infant; Middle Aged; ABO Blood-Group System; Liver Transplantation; 3. Good health; The Second COVID-19 Minisymposium; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Blood Group Incompatibility; Living Donors; Humans; Surgery; Female; Postoperative Period

Living-donor liver transplantation (LDLT) has been mostly suspended and deceased-donor living transplantation activity has been considerably reduced because of coronavirus disease 2019 (COVID-19). We modified our protocols and procedures in line with COVID-19 guidelines. Since the restructuring, we have performed 20 LDLTs. Our study reports the outcomes of these cases and demonstrates the feasibility of LDLT during this pandemic.The changes were influenced by experiences and communications from across the globe. A month-long self-imposed moratorium was spent in restructuring the program and implementing new protocols. Twenty LDLTs were performed between April 18 and September 15 using the new protocols. Our experience includes 2 simultaneous liver-kidney transplants, 1 ABO-incompatible LDLT, and 1 pediatric case (age 11 months).Nineteen patients recovered and 1 patient died. We maintained our postoperative immunosuppression protocol without many changes. Major complications were observed in 30% of recipients but none of the donors. One recipient was infected with COVID-19 during the postoperative period. A donor-recipient couple contracted COVID-19 after discharge from the hospital. All patients recovered from COVID-19 and liver enzymes were unaffected.This study represents a microcosm of experience in LDLT during the COVID-19 era. Outcomes of LDLT are not affected by COVID-19 per se, provided that we make necessary changes.