Transplant of SARS-CoV-2–infected Living Donor Liver: Case Report

Michelle C. Nguyen, MD, MPH; Eliza J. Lee, MD; Robin K. Avery, MD; M. Veronica Dioverti-Prono, MD; Shmuel Shoham, MD; Aaron A. R. Tobian, MD, PhD; Evan M. Bloch, MBChB; Ahmet Gurakar, MD; Nicole A. Rizkalla, MD; Andrew M. Cameron, MD, PhD; Elizabeth A. King, MD, PhD; Shane Ottmann, MD; Jacqueline M. Garonzik-Wang, MD, PhD; Russel N. Wesson, MBChB; Benjamin Philosophe, MD, PhD

doi:10.1097/TXD.0000000000001178

Transplantation Direct (Aug 2021)

Transplant of SARS-CoV-2–infected Living Donor Liver: Case Report

Michelle C. Nguyen, MD, MPH,
Eliza J. Lee, MD,
Robin K. Avery, MD,
M. Veronica Dioverti-Prono, MD,
Shmuel Shoham, MD,
Aaron A. R. Tobian, MD, PhD,
Evan M. Bloch, MBChB,
Ahmet Gurakar, MD,
Nicole A. Rizkalla, MD,
Andrew M. Cameron, MD, PhD,
Elizabeth A. King, MD, PhD,
Shane Ottmann, MD,
Jacqueline M. Garonzik-Wang, MD, PhD,
Russel N. Wesson, MBChB,
Benjamin Philosophe, MD, PhD

Affiliations

Michelle C. Nguyen, MD, MPH: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Eliza J. Lee, MD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Robin K. Avery, MD: 2 Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
M. Veronica Dioverti-Prono, MD: 2 Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Shmuel Shoham, MD: 2 Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Aaron A. R. Tobian, MD, PhD: 3 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
Evan M. Bloch, MBChB: 3 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
Ahmet Gurakar, MD: 4 Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.
Nicole A. Rizkalla, MD: 5 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Andrew M. Cameron, MD, PhD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Elizabeth A. King, MD, PhD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Shane Ottmann, MD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Jacqueline M. Garonzik-Wang, MD, PhD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Russel N. Wesson, MBChB: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Benjamin Philosophe, MD, PhD: 1 Division of Transplant Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

DOI: https://doi.org/10.1097/TXD.0000000000001178
Journal volume & issue: Vol. 7, no. 8
p. e721

Abstract

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Given the high community prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transplant programs will encounter SARS-CoV-2 infections in living donors or recipients in the perioperative period. There is limited data on SARS-CoV-2 viremia and organotropism beyond the respiratory tract to inform the risk of transplant transmission of SARS-CoV-2. We report a case of a living donor liver transplant recipient who received a right lobe graft from a living donor with symptomatic PCR-confirmed SARS-CoV-2 infection 3 d following donation. The donor was successfully treated with remdesivir, dexamethasone, and coronavirus disease 2019 (COVID-19) convalescent plasma. No viral transmission was identified, and both donor and recipient had excellent postoperative outcomes.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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