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. 2021 May;53(4):1118-1125.
doi: 10.1016/j.transproceed.2020.10.049. Epub 2020 Dec 16.

Restarting LDLT During COVID-19: Early Results After Restructuring

Sandeep K Jha  1 , Imtiakum Jamir  2 , Kshitij Sisodia  2 , Niteen Kumar  2 , Gaurav Sood  2 , Nitin Shanker  3 , Sachin Anand  3 , Gaurav Dubey  4 , Vinod Choudhary  4 , Pankaj Lohia  3 , Amit Singhal  4 , Manav Wadhawan  5 , Ajay Kumar  5 , Abhideep Chaudhary  2
Affiliations

Restarting LDLT During COVID-19: Early Results After Restructuring

Sandeep K Jha et al. Transplant Proc. 2021 May.

Abstract

Introduction: 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.

Materials and methods: 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).

Results: 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.

Conclusion: 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.

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Figures

Fig 1
Fig 1
Current coronavirus disease 2019 situation in India [20,21].
See this image and copyright information in PMC

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