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Review
. 2021 Sep 5;10(17):4015.
doi: 10.3390/jcm10174015.

COVID-19 in Liver Transplant Recipients: A Systematic Review

Chiara Becchetti  1   2 , Sarah Gabriela Gschwend  1 , Jean-François Dufour  1   2 , Vanessa Banz  1
Affiliations
Review

COVID-19 in Liver Transplant Recipients: A Systematic Review

Chiara Becchetti et al. J Clin Med. .

Abstract

Liver transplant (LT) recipients are considered a vulnerable population amidst the COVID-19 pandemic. To date, available data have been heterogeneous and scarce. Therefore, we conducted a systematic literature review identifying English-language articles published in PubMed between November 2019 and 30 May 2021. We aimed to explore three areas: (1) outcome and clinical course; (2) immunological response after COVID-19 in LT recipients; and (3) vaccination response. After systematic selection, 35, 4, and 5 articles, respectively, were considered suitable for each area of analysis. Despite the heterogeneity of the reports included in this study, we found that gastrointestinal symptoms were common in LT recipients. The outcome of the LT population was not per se worse compared to the general population, although careful management of immunosuppressive therapy is required. While a complete therapy discontinuation is not encouraged, caution needs to be taken with use of mycophenolate mofetil (MMF), favoring tacrolimus (TAC) use. Although data conflicted about acquired immunity after SARS-CoV-2 infection, vaccine immunogenicity appeared to be low, suggesting that the level of surveillance should be kept high in this population.

Keywords: SARS-CoV-2; humoral response; immunosuppressant; liver injury; solid organ transplantation; vaccination.

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Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow diagram of the systematic literature search according to the PRISMA statement.
Figure 2
Figure 2
Graphical representation of the key unresolved issues for SARS-CoV-2 infection in LT recipients.
See this image and copyright information in PMC

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