Impact of immunosuppressant agents on post liver transplant patients with COVID‐19

2021 ◽  
Vol 17 ◽  
Author(s):  
Rozita Khodashahi ◽  
Mohsen Aliakbarian ◽  
Mandana Khodashahi
Keyword(s):  
Liver Transplant ◽  
Late Phase ◽  
Previous Treatment ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Transplant Patients ◽  
Liver Transplant Recipients

Background: It seems that transplant recipients are at high risk for severe COVID-19, especially in the presence of comorbidities and immunosuppression. This study aimed to determine the effects of previous treatment with immunosuppressants and received dosage and the risk of COVID-19 severity and mortality in liver transplant recipients in various post-transplantation phases in the Iranian population. Methods: : This was a cross-sectional study conducted among 24 patients in the post liver transplant course, who were referred to two transplant centers (Imam Reza and Montaseriyeh hospitals) affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, during 2020-2021. The demographic and clinical characteristics of the patients were recorded in a checklist, and the relationships between various variables were analyzed. Results: The majority of the post liver transplant patients(96%) were in the late phase of post-transplantation, and 8.3% of the cases expired. COVID-19 severity and mortality did not show a significant relationship with previous treatment with immunosuppressants and received dosage (P>0.05). In addition, there was no relationship between the symptoms of COVID-19 and immunosuppressant dosages, except for a headache. No significant correlation was found between immunosuppressants dosage and laboratory findings, and only prednisolone dosage was found to be correlated with heart rate (r=-0.62, P=0.03), BUN (r=-0.84, P=0.002), and D-dimer (r=-0.72, P=0.01). Conclusion: Severe SARS-CoV-2 infection was reported in the majority of liver transplant recipients. The severity of COVID-19 was not related to previous treatment with immunosuppressants and received dosage

scholarly journals Variations in TM6SF2, PCSK9 and PCSK7 genes and risk of hepatic steatosis after liver transplantation: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahad Eshraghian ◽  
Elham Moasser ◽  
Negar Azarpira ◽  
Mohammad Reza Fattahi ◽  
Saman Nikeghbalian ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Hepatic Steatosis ◽  
Cross Sectional Study ◽  
Genetic Variations ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Proprotein Convertase ◽  
Cross Sectional ◽  
Liver Transplant Recipients

Abstract Background Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/kexin type 7 (PCSK7) rs2277287 with hepatic steatosis in liver transplant recipients. Methods In a cross-sectional study, adult (> 18 years) liver transplant recipients who were referred for their routine post-transplant follow-up between June 2018 and September 2018 were included in the study. Hepatic steatosis in transplant recipients was assessed by controlled attenuation parameter (CAP). Polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) was used to study TM6SF2 rs58542926, PCSK7 rs2277287 and PCSK9 rs505151 genotypes. Results 107 liver transplant recipients were included. There was no association between different genotypes of PCSK9 rs505151 and PCSK7 rs2277287 with hepatic steatosis in liver transplant recipients (P value > 0.05). The presence of TT genotype of TM6SF2 rs58542926 was higher in patients with hepatic steatosis measured by CAP after liver transplantation. In patients with moderate and severe hepatic steatosis (grade 2 and 3 steatosis), AG + GG genotypes of PCSK9 rs505151 were more prevalent than AA genotype (OR 8.667; 95% CI 1.841–40.879; P value = 0.004) compared to patients with mild steatosis (grade 1). In multivariate regression model, AG + GG genotypes of PCSK9 rs505151 were associated with moderate and severe steatosis in liver transplant recipients (OR 5.747; 95% CI 1.086–30.303; P value = 0.040). Conclusions Genetic variations in TM6SF2 rs58542926 and PCSK9 rs505151 might be associated with hepatic steatosis in liver transplant recipients.

scholarly journals Renal Safety of Tenofovir Disoproxil Fumarate and Entecavir in Liver Transplant Patients: A Nationwide Korean Registry Study

2021 ◽  
Author(s):  
Juhan Lee ◽  
Jae Geun Lee ◽  
Shin Hwang ◽  
Kwang-Woong Lee ◽  
Jong Man Kim ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Renal Dysfunction ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Increased Risk ◽  
B Virus ◽  
Liver Transplant Recipients ◽  
Renal Safety

Abstract Background and aims: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) have been recommended after liver transplantation to prevent recurrence of hepatitis B virus infection. Despite its proven efficacy, the renal safety of TDF has not been established in liver transplant recipients. We aimed to compare the effects of TDF and ETV on renal function in liver transplant recipients and to evaluate risk factors for renal dysfunction after liver transplantation. Methods: This is a retrospective, observational multicenter study of data from the Korean Organ Transplantation Registry. We included adults who underwent liver transplantation for hepatitis B virus-related complications from April 2014 to December 2017 and received TDF or ETV post-transplantation. Renal dysfunction was defined as an estimated glomerular filtration rate decline by at least 20% from baseline (1 month post-transplantation). Median duration of follow-up was 29 months (interquartile range 19–42).Results: A total of 804 liver transplant patients were included. The cumulative probability of renal dysfunction was significantly higher in the TDF group than in the ETV group. Multivariable analysis confirmed that TDF was independently associated with an increased risk of renal dysfunction (hazard ratio = 1.47, 95% confidence interval 1.12-1.92; P = 0.005). Independent risk factors for renal dysfunction included older age, worse baseline renal function, and low body mass index. Renal dysfunction after liver transplantation was independently associated with increased mortality.Conclusions: In this nationwide study, use of TDF was associated with an increased risk of renal dysfunction, when compared with ETV.

scholarly journals Fatigue and its associated factors in liver transplant recipients in Beijing: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e011840 ◽  
Author(s):  
Xiao-Hong Lin ◽  
Sha Teng ◽  
Lu Wang ◽  
Jing Zhang ◽  
Ya-Bin Shang ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Transplant Recipients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Liver Transplant Recipients

Comparison between kidney and liver transplant recipients admitted to a referral center regarding coronavirus-2019 manifestations in the Northeast of Iran during three peaks of pandemic

2021 ◽  
Vol 17 ◽  
Author(s):  
Mohsen Aliakbarian ◽  
Rozita Khodashahi ◽  
Mahin Ghorban Sabbagh ◽  
Hamid Reza Naderi ◽  
Mandana Khodashahi ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
High Risk ◽  
Liver Transplant ◽  
Severe Infection ◽  
Clinical Findings ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Liver Transplant Recipients

Background: Transplant recipients are at high risk for severe Coronavirus disease-2019 (COVID-19). Transplant recipients are immune-compromised individuals at high risk for severe infection. This study aimed to compare the presentations and outcomes of liver and kidney transplant recipients who were infected with COVID-19 in the Iranian population. Methods: This cross-sectional study was conducted at Imam Reza and Montaserieh Hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, between 2020 and 2021. In general, 52 patients were selected and divided into two groups of the kidney (n=28) and liver (n=24) transplantation. Two groups were compared in terms of demographic characteristics and clinical findings. Results: Of 52 patients, severe COVID-19 infection was reported in 61% of the patients. There was no significant difference between the two groups in terms of symptoms, except for cough (χ2=8.09; P=0.004), clinical condition, and laboratory symptoms, except for creatinine (Z=14; P<0.005), alkaline phosphatase (Z=4.55; P=0.03), total bilirubin (Z=8.93; P=0.03), and partial thromboplastin time (Z=5.97; P=0.01). There was no relationship between the outcome and the use of immunosuppressive medications (P>0.05). All patients with kidney transplantation survived, while two cases in the liver transplantation group failed to survive (χ2=2.42; P=0.11). Conclusion: The mortality rate was higher in the liver transplant recipients, compared to the patients who underwent kidney transplantation.

Pleural Effusions Following Liver Transplantation: A Single-Center Experience

2020 ◽  
pp. 088506662093244
Author(s):  
Justin K. Lui ◽  
Lidia Spaho ◽  
Shahrad Hakimian ◽  
Michael Devine ◽  
Rosa Bui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Hospital Length Of Stay ◽  
Transplant Recipients ◽  
Single Center ◽  
Pleural Effusions ◽  
Post Transplantation ◽  
Significant Difference ◽  
Liver Transplant Recipients

Introduction: This was a single-center retrospective study to evaluate incidence, prognosis, and risk factors in patients with postoperative pleural effusions, a common pulmonary complication following liver transplantation. Methods: A retrospective review was performed on 374 liver transplantation cases through a database within the timeframe of January 1, 2009 through December 31, 2015. Demographics, pulmonary and cardiac function testing, laboratory studies, intraoperative transfusion/infusion volumes, postoperative management, and outcomes were analyzed. Results: In the immediate postoperative period, 189 (50.5%) developed pleural effusions following liver transplantation of which 145 (76.7%) resolved within 3 months. Those who developed pleural effusions demonstrated a lower fibrinogen (149.6 ± 66.3 mg/dL vs 178.4 ± 87.3 mg/dL; P = .009), total protein (5.8 ± 1.0 mg/dL vs 6.1 ± 1.2 mg/dL; P = .04), and hemoglobin (9.8 ± 1.8 mg/dL vs 10.3 ± 1.9 mg/dL; P = .004). There was not a statistically significant difference in 1-year all-cause mortality and in-hospital mortality between liver transplant recipients with and without pleural effusions. Liver transplant recipients who developed pleural effusions had a longer hospital length of stay (16.4 ± 10.9 days vs 14.0 ± 16.5 days; P = .1), but the differences were not statistically significant. However, there was a significant difference in tracheostomy rates (11.6% vs 5.4%; P = .03) in recipients who developed pleural effusions compared to recipients who did not. Conclusions: In summary, pleural effusions are common after liver transplantation and are associated with increased morbidity. Pre- and intraoperative risk factors can offer both predictive and prognostic value for post-transplantation pleural effusions. Further prospective studies will be needed to further evaluate the relevance of these findings to limit instances of postoperative pleural effusions.

scholarly journals Effect of CYP3A5 on the Once-Daily Tacrolimus Conversion in Stable Liver Transplant Patients

2020 ◽  
Vol 9 (9) ◽  
pp. 2897
Author(s):  
Jong Man Kim ◽  
Je Ho Ryu ◽  
Kwang-Woong Lee ◽  
Suk Kyun Hong ◽  
Kwangho Yang ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Extended Release ◽  
Trough Level ◽  
Pharmacokinetic Analysis ◽  
Transplant Recipients ◽  
Open Label ◽  
Once Daily ◽  
Transplant Patients ◽  
Liver Transplant Recipients ◽  
Cyp3a5 Polymorphism

Cytochrome P450 (CYP) 3A5 polymorphism influences tacrolimus metabolism, but its effect on the drug pharmacokinetics in liver transplant recipients switched to once-daily extended-release formulation remains unknown. The aim of this study is to analyze the effect of CYP3A5 polymorphism on liver function after once-daily tacrolimus conversion in liver transplant patients. A prospective open-label study included 60 stable liver transplant recipients who underwent 1:1 conversion from twice-daily tacrolimus to once-daily tacrolimus. All participants were genotyped for CYP3A5 polymorphism. The study was registered at ClinicalTrials.gov (NCT 02882113). Twenty-eight patients were enrolled in the CYP3A5 expressor group and 32 in the non-expressor group. Although there was no statistical difference, incidence of liver dysfunction was higher in the expressor group than in the non-expressor group when converted to once-daily extended-release tacrolimus (p = 0.088). No biopsy-proven acute rejection, graft failure, and mortality were observed in either group. The decrease in dose-adjusted trough level (−42.9% vs. −26.1%) and dose/kg-adjusted trough level of tacrolimus (−40.0% vs. −23.7%) was significantly greater in the expressor group than in the non-expressors after the conversion. A pharmacokinetic analysis was performed in 10 patients and tacrolimus absorption in the non-expressor group was slower than in the expressor group. In line with this observation, the area under the curve for once-daily tacrolimus correlated with trough level (Cmin) in the non-expressors and peak concentration (Cmax) in the expressors. CYP3A5 genotyping in liver transplant recipients leads to prediction of pharmacokinetics after switching from a twice-daily regimen to a once-daily dosage form, which makes it possible to establish an appropriate dose of tacrolimus.

scholarly journals Detection of human herpesvirus-7 by qualitative nested-PCR: comparison between healthy individuals and liver transplant recipients

2008 ◽  
Vol 41 (6) ◽  
pp. 556-559 ◽  
Author(s):  
Ronaldo Luis Thomasini ◽  
Juliana de Moraes Martins ◽  
Daniela Corte Parola ◽  
Sandra Helena Alves Bonon ◽  
Ilka de Fátima Santana Ferreira Boin ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Healthy Volunteers ◽  
Nested Pcr ◽  
Human Herpesvirus ◽  
Transplant Recipients ◽  
Healthy Individuals ◽  
Active Infection ◽  
Serological Tests ◽  
Transplant Patients ◽  
Liver Transplant Recipients

Diagnosis of human herpesvirus-7 active infection in transplant patients has proved difficult, because this virus is ubiquitous and can cause persistent infections in the host. The significance of viral DNA detected in leukocytes by PCR is unclear and cross-reaction in serological tests may occur. This study aimed to evaluate nested-PCR to detect human herpesvirus-7 active infection in liver transplant recipients compared to healthy individuals. human herpesvirus-7 nested-PCR was performed on leukocytes and sera of 53 healthy volunteers and sera of 29 liver transplant recipients. In healthy volunteers, human herpesvirus-7 was detected in 28.3% of leukocytes and 0% of serum. human herpesvirus-7 was detected in sera of 48.2% of the liver transplant recipients. Nested-PCR on DNA extracted from leukocytes detected latent infection and the study suggests that nested-PCR performed on serum could be useful to detect human herpesvirus-7 active infection in liver transplant recipients.

Sign in / Sign up

Export Citation Format

Share Document