scholarly journals Clinical course and challenging management of early COVID-19 infection after heart transplantation: Case report of two patients

2020 ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie pierre Hayette ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Clinical Course ◽  
Asymptomatic Carrier ◽  
Case Reports ◽  
Organ Transplant ◽  
Case Series ◽  
Perioperative Period ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

Abstract Background: There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients and especially in heart transplant recipients with only few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation: This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplants recipients who were tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease, and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions: These two cases illustrate the severity and the poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory and the issue of asymptomatic carrier need to be addressed.

scholarly journals Clinical course and challenging management of early COVID-19 infection after heart transplantation: case report of two patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie Pierre Hayette ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Clinical Course ◽  
Case Reports ◽  
Organ Transplant ◽  
Case Series ◽  
Perioperative Period ◽  
Severe Form ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

Abstract Background There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplant recipients who tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions These two cases illustrate the severity and poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory, and the issue of asymptomatic carriers needs to be addressed.

scholarly journals Coronavirus disease 2019 outcomes in heart transplant recipients: a single-center case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Farah Naghashzadeh ◽  
Shadi Shafaghi ◽  
Babak Sharif-Kashani ◽  
Payam Tabarsi ◽  
Leila Saliminejad ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Organ Transplant ◽  
Case Series ◽  
Outpatient Setting ◽  
Clinical Severity ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Treatment Data ◽  
Heart Transplant Recipients

Abstract Background With the rapidly expanding pandemic of severe acute respiratory syndrome coronavirus-2, a chronic immunosuppressed state in solid organ transplant recipients is a concern. We reported coronavirus disease 2019 in heart transplant recipients and described the patients’ course from diagnosis to either hospital admission or improvement in symptoms. Case presentation This study retrospectively identified 13 white (Iranian) heart transplant patients with coronavirus disease 2019 between December 2019 and October 2020. The mean age of patients was 43.7 years (19–65 years); seven (70%) were men. Laboratory and treatment data were collected for those admitted or managed as outpatients. Outcomes were also recorded for all patients. This report demonstrates a range of symptoms, clinical severity, and disease course in heart transplant recipients with coronavirus disease 2019, including ten hospitalized patients and three patients, managed entirely in the outpatient setting. One patient passed away, and none of them experienced an episode of clinically overt rejection. Conclusions We would like to emphasize the importance of being alert in these patients to consider testing in a broad range of clinical presentations and gathering more data for better management.

scholarly journals Treatment of Acute Tacrolimus Toxicity with Phenytoin in Solid Organ Transplant Recipients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Arin S. Jantz ◽  
Samir J. Patel ◽  
Wadi N. Suki ◽  
Richard J. Knight ◽  
Arvind Bhimaraj ◽  
...  
Keyword(s):  
Case Reports ◽  
Elevated Serum ◽  
Organ Transplant ◽  
Case Series ◽  
Solid Organ Transplant ◽  
Tacrolimus Concentration ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

The pharmacokinetics of tacrolimus are influenced by many factors, including genetic variability, acute infections, liver dysfunction, and interacting medications, which can result in elevated concentrations. The most appropriate management of acute tacrolimus toxicity has not been defined though case reports exist describing the therapeutic use of enzyme inducers to increase tacrolimus metabolism and decrease concentrations. We are reporting on the utilization of phenytoin to assist in decreasing tacrolimus concentrations in a case series of four solid organ transplant recipients with acute, symptomatic tacrolimus toxicity presenting with elevated serum creatinine, potassium, and tacrolimus trough concentrations greater than 30 ng/mL. All four patients had the potential causative agents stopped or temporarily held and were given 300 to 400 mg/day of phenytoin for two to three days. Within three days of beginning phenytoin, all four patients had a decrease in tacrolimus concentration to less than 15 ng/mL, a return to or near baseline creatinine concentration, and lack of phenytoin-related side effects. Therefore, phenytoin appears to be a safe and potentially beneficial treatment option in patients with symptomatic tacrolimus toxicity.

scholarly journals Adherence to Immunosuppression Medications among Heart Transplant Recipients: Challenges, Opportunities, and Potential Role of Digital Approaches in the COVID-19 Era

2021 ◽  
Vol 8 (6) ◽  
pp. 68
Author(s):  
Tasmeen Hussain ◽  
Keira Nassetta ◽  
Sherif M. Badawy
Keyword(s):  
Heart Transplant ◽  
Potential Role ◽  
Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Adherence Behavior ◽  
Unique Challenge ◽  
Heart Transplant Recipients

Society and medical practice have been restructured dramatically to avoid further spread of the COVID-19 virus; telehealth/telemedicine, mask wearing, and nationwide social distancing practices have become widespread. However, we still face unprecedented challenges in fields where patients require frequent and active follow-up visits for monitoring, including that of solid-organ transplant, and in particular, heart transplant. Adherence to immunosuppression remains a unique challenge in heart transplantation, especially during the COVID-19 pandemic. Failure to adhere to immunosuppression can have disastrous consequences, including graft rejection and death. In this article, we discuss challenges related to adherence to immunosuppression medications among heart transplant recipients, as well as opportunities to leverage digital approaches and interventions to monitor and optimize adherence behavior and health outcomes in this population.

scholarly journals COVID‐19 in solid organ transplant recipients: A single‐center case series from Spain

2020 ◽  
Vol 20 (7) ◽  
pp. 1849-1858 ◽  
Author(s):  
Mario Fernández‐Ruiz ◽  
Amado Andrés ◽  
Carmelo Loinaz ◽  
Juan F. Delgado ◽  
Francisco López‐Medrano ◽  
...  
Keyword(s):  
Organ Transplant ◽  
Case Series ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Single Center ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Insights From Practice With Use of Direct Oral Anticoagulants in Transplantation

2018 ◽  
Vol 28 (4) ◽  
pp. 380-385
Author(s):  
Razan Alsheikh ◽  
Osamah M. Alfayez ◽  
Majed S. Al Yami
Keyword(s):  
Case Reports ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Organ Transplant ◽  
Case Series ◽  
Solid Organ ◽  
Special Population ◽  
Retrospective Case ◽  
Transplant Patients ◽  
Attractive Option

Solid organ transplant patients are at risk of developing atrial fibrillation and venous thromboembolism. Direct oral anticoagulants are considered an attractive option for anticoagulation in patients due to their convenience; however, strong evidence of their use in transplantation is lacking. We conducted a search using Pubmed, Embase, and Scopus databases, in addition to International Society of Heart and Lung transplantation and American Transplant Congress abstracts (from 2012 through December 2017). Fourteen articles were reviewed that included case reports, retrospective case series, or chart review analyses of small cohorts. Based on this review, the findings can only generate hypotheses that should be further studied in a larger randomized cohort. This review can help clinicians gain insight into the use of direct oral anticoagulant in this special population. For now, clinicians should be cautious about their use in this special population.

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