Organ Transplant Center Management and Patient Monitoring During Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2/COVID-19) Pandemia

Year 2021, , 131 - 136, 25.06.2020

M. Burak Dal

https://doi.org/10.5455/umj.20210105064115

Abstract

Introduction: COVID-19 is a viral infectious disease that affects more than 200 countries in the world and has been declared a pandemic by the World Health Organization. This article provides some strategies for the management of the organ transplant unit in the COVID-19 outbreak or other respiratory infections.
Materials and Methods: Organ transplantation clinics, services or intensive care units are potential sources of transmission during this pandemic. Therefore, it is imperative for hospitals and organ transplant centers to organize management strategies for organ transplant patients during the COVID-19 outbreak. The study shared our special precautions and protocols created by a clinic that conducts over 1300 liver and 1500 kidney transplants.
Results: Five live donor liver transplants were performed in our clinic. A total of 8 patients are in our service and in
the intensive care unit. Two patients who underwent live donor liver transplantation stay in the intensive care unit, and 2 patients with Post-op 2 donor and transplant preparation. COVID-19 infection was not detected in patients who underwent live donor solid organ transplantation and were followed up in our service.
Conclusion: It is important to have the arrangement to prevent and control the transmission of COVID-19 and to manage the organ transplant clinic during this period. A method that can protect both the hospital staff and the medical team and patients should be determined. Liver transplantation with live donors increases donor risk; on the other hand, it also provides important advantages such as planning the operation time, insulating the transmitter, and providing sufficient and repeated tests. We think that we performed liver transplantation in the safest possible environment by following the guidelines adopted in our clinic.

Keywords

Organ transplant, acute respiratory syndrome, coronavirus, pandemia

References

• 1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506
• 2. Republic of Turkey Ministry of Health, General Directorate of Health Services Tissue, Organ Transplantation and Dialysis Services Department. Infection Control Precautions To Be Taken In COVID-19 Organ And Stem Cell Transplantation Centers. Available from: https://organ.saglik.gov.tr/AllNews. aspxq=6sdAUde7U6ZJ/p9nbmcVUO2zRQ+hJVFGLin1h3Ce41+XYa23ngczV2Ht9XpFtV3e
• 3.Michaels MG, La Hoz RM, Danziger Isakov L, Kumar D, Pruett T. Coronavirus Disease 2019: Implications of Emerging Infections for Transplantation. Am J Transplant. 2020
• 4. Gandolfini I, Delsante M, Fiaccadori E, Zaza G, Manenti L, Degli Antoni A et al. COVID-19 in Kidney Transplant Recipients. Am J Transplant 2020
• 5. Rosenthal PJ. The Importance of Diagnostic Testing during a Viral Pandemic: Early Lessons from Novel Coronavirus Disease (COVID-19). Am J Trop Med Hyg 2020
• 6. Kumar D, Tellier R, Draker R, Levy G, Humar A. Severe Acute Respiratory Syndrome (SARS) in a liver transplant recipient and guidelines for donor SARS screening. Am J Transplant 2003;3(8):977-981
• 7. AlGhamdi M, Mushtaq F, Awn N, Shalhoub S. MERS CoV infection in two renal transplant recipients: case report. Am J Transplant 2015;15(4):1101-1104
• 8. Boyarsky BJ, Werbel WA, Durand C, Jackson KR, Kernodle AB, Rasmussen S van P, et al. Early Impact of COVID-19 on Transplant Center Practices and Policies in the United States. Am J Transplant. 2020
• 9.Hongling Liu, He X, Wang Y, Zhou S, Zhang D, Zhu J et al. Management of COVID-19 in the patients after liver transplantation: Beijing working party for liver transplantation. Hepatol Int. 2020;Apr 10:1–5
• 10.Karaca AS, Ozmen MM, Ucar AD, Yastı AC, Demirer S. COVID-19’lu Hastalarda Genel Cerrahi Ameliyathane Uygulamaları Turk J Surg 2020;36(1):6-10
• 11. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) A Review. JAMA. 2020 Apr 13
• 12.Guillen E, Pineiro GJ, Revuelta I, Rodriguez D, Bodro M, Morenso Asuncion, et al. Case report of COVID-19 in a kidney transplant recipient: Does immunosuppression alter the clinical presentation? Am J Transplant. 2020 Mar 20;10.1111
• 13.Tran K, Cimon K, Severn M, Pessoa Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PloS One, 2012;7(4):e35797.
• 14.WHO. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected (Interimuidance). Available from: https://www. who.int/docs/ default-source/coronaviruse/20200126-ncov-ipc-during-health-care.pdf.