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Multicenter Study
. 2023 Dec;37(12):e15141.
doi: 10.1111/ctr.15141. Epub 2023 Sep 27.

Liver transplantation for post-COVID-19 cholangiopathy: A case series

Yuzuru Sambommatsu  1 , Charles Mouch  2 , Anand V Kulkarni  3 , David A Bruno  1 , Mehdi Eslami  1 , Daisuke Imai  1 , Seung Duk Lee  1 , Aamir A Khan  1 , Amit Sharma  1 , Muhammad Saeed  1 , Adrian H Cotterell  1 , Marlon F Levy  1 , Megan K Morales  4 , Martin I Montenovo  2 , Padaki N Rao  3 , Raghuram Reddy  5 , Balachandran Menon  5 , Vinay Kumaran  1
Affiliations
Multicenter Study

Liver transplantation for post-COVID-19 cholangiopathy: A case series

Yuzuru Sambommatsu et al. Clin Transplant. 2023 Dec.

Abstract

Background: Post-COVID-19 cholangiopathy is an emerging cholestatic liver disease observed in patients recovering from severe COVID-19 infection. Its prognosis is poor, necessitating liver transplantation in some cases. This study aimed to investigate the outcomes of liver transplantation for post-COVID-19 cholangiopathy.

Methods: Seven patients who underwent liver transplantation for post-COVID-19 cholangiopathy at three institutions between 2020 and 2022 were included in this retrospective multi-center case series.

Results: At the time of initial COVID-19 infection, all patients developed acute respiratory distress syndrome, and six patients (86%) required ICU admission. Median time intervals from the initial COVID-19 diagnosis to the diagnosis of post-COVID-19 cholangiopathy and liver transplantation were 4 and 12 months, respectively. Four patients underwent living donor liver transplantation, and three patients underwent deceased donor liver transplantation. The median MELD score was 22 (range, 10-38). No significant intraoperative complications were observed. The median ICU and hospital stays were 2.5 and 12.5 days, respectively. One patient died due to respiratory failure 5 months after liver transplantation. Currently, the patient and graft survival rate is 86% at a median follow-up of 11 months.

Conclusions: Liver transplantation is a viable option for patients with post-COVID-19 cholangiopathy with acceptable outcome. Timely identification of this disease and appropriate management, including evaluation for liver transplantation, are essential.

Keywords: COVID-19; SARS-CoV-2; coronavirus; liver transplantation.

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References

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