PDF(Pubmed)
Abstract：
This article discusses the current scene of liver transplantation (LT) in light of the impact of COVID-19, with particular emphasis on the possibility of graft injury and re-transplantation in LT patients infected with SARS-CoV-2. A major concern is whether such patients experience a more severe form of disease which may lead to a higher risk of acute, irreversible liver injury. If this is serious, it may necessitate re-transplantation. This article aims to raise awareness in this relatively under-researched domain. More studies are required to evaluate this issue since it has strong implications in healthcare resource allocation and clinical decision-making. Several potential research directions are proposed, including the possibility of prolonging bridging therapy for non-urgent LT cases: patients with hepatocellular carcinoma; and whether hepatoprotective agents play a role in liver-sparing during SARS-CoV-2 infection. There is also substantial discussion of the relevance of lung injury in LT patients with COVID-19 since it is not uncommon regarding the high expression of ACE2 receptors in the lungs, and that lung injury remains the major cause of death in patients with chronic liver disease.
摘要：
本文根据COVID-19的影响讨论了肝移植（LT）的现状，特别强调了感染SARS-CoV-2的LT患者的移植物损伤和重新移植的可能性。一个主要的问题是这些患者是否经历了更严重的疾病形式，这可能导致更高的急性，不可逆的肝损伤。如果这很严重,这可能需要重新移植。本文旨在提高这一相对研究不足的领域的认识。需要更多的研究来评估这个问题，因为它对医疗保健资源分配和临床决策具有重要意义。提出了几个潜在的研究方向，包括延长非紧急LT病例桥接治疗的可能性：肝细胞癌患者；以及在SARS-CoV-2感染期间，肝保护剂是否在肝脏保护中起作用。也有实质性的讨论与LT患者的肺损伤的相关性与COVID-19，因为它是关于肺ACE2受体的高表达并不少见，肺损伤仍然是慢性肝病患者死亡的主要原因。
