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Review
. 2021 Mar 14;27(10):928-938.
doi: 10.3748/wjg.v27.i10.928.

Impact of the COVID-19 pandemic on liver donation and transplantation: A review of the literature

Riccardo De Carlis  1 , Ivan Vella  2 , Niccolò Incarbone  2 , Leonardo Centonze  2 , Vincenzo Buscemi  2 , Andrea Lauterio  2 , Luciano De Carlis  2
Affiliations
Review

Impact of the COVID-19 pandemic on liver donation and transplantation: A review of the literature

Riccardo De Carlis et al. World J Gastroenterol. .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has upended healthcare systems worldwide and led to an inevitable decrease in liver transplantation (LT) activity. During the first pandemic wave, administrators and clinicians were obliged to make the difficult decision of whether to suspend or continue a life-saving procedure based on the scarce available evidence regarding the risk of transmission and mortality in immunosuppressed patients. Those centers where the activity continued or was heavily restricted were obliged to screen donors and recipients, design COVID-safe clinical pathways, and promote telehealth to prevent nosocomial transmission. Despite the ever-growing literature on COVID-19, the amount of high-quality literature on LT remains limited. This review will provide an updated view of the impact of the pandemic on LT programs worldwide. Donor and recipient screening, strategies for waitlist prioritization, and posttransplant risk of infection and mortality are discussed. Moreover, a particular focus is given to the possibility of donor-to-recipient transmission and immunosuppression management in COVID-positive recipients.

Keywords: Donor and recipient screening; Donor-to-recipient transmission; Immunosuppression; Liver cirrhosis; Resource allocation in transplantation; Severe acute respiratory syndrome coronavirus type 2.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interests for this article.

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