Challenges for liver transplantation during recovery from the COVID-19 pandemic: insights and recommendations
Niriella, M A Siriwardana, R C Perera, M T P R Narasimhan, G Chan, S C Dassanayake, A S
Niriella, M A
Siriwardana, R C
Perera, M T P R
Narasimhan, G
Chan, S C
Dassanayake, A S
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is placing an increasing burden on liver transplant (LT) services worldwide. At the peak of the pandemic, many LT services worldwide reduced or halted their activities. With the gradual easing of lockdowns, LT teams face new challenges when restarting activities. The numbers of LTs are likely to drop in the immediate post-COVID era. Prolonged and intermittent lockdowns are likely to lead to a shortage of supplies, especially in poor resource settings. Special attention is needed to avoid nosocomial COVID-19 infection among cirrhotic patients awaiting transplant, post-transplant patients, and members of transplant teams. LT programs may have to revise existing strategies in selecting donors and recipients for transplants. Redesigning service provision, restructuring outpatient care, carefully screening and selecting donors and recipients, and performing LT with limited resources will have to be initiated in the post-COVID era if long-term recovery of LT services is to be expected. Costs involved with LT are likely to increase, considering the change in protocols of testing, quarantining, and interstate traveling. This paper discusses the different elements affecting and the widespread impact of the COVID-19 pandemic on LT and strategies to minimize the impact of these factors and to adapt so LT services can meet the health care needs during this pandemic and beyond.
MIDER Authors
Affiliations
University of Kelaniya; University Hospitals Birmingham NHS Foundation Trust; Dr Rela Institute & Medical Centre; The University of Hong Kong
Date
2020-06-04
Type
Article
Collections
Citation
Niriella MA, Siriwardana RC, Perera MTPR, Narasimhan G, Chan SC, Dassanayake AS. Challenges for Liver Transplantation During Recovery From the COVID-19 Pandemic: Insights and Recommendations. Transplant Proc. 2020 Nov;52(9):2601-2606. doi: 10.1016/j.transproceed.2020.05.032. Epub 2020 Jun 4.