P-97 COLOMBIAN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH SARS-CoV-2 INFECTION AND LIVER TRANSPLANTATION

Introduction

Many authors have highlighted the management and outcomes of liver transplant patients with SARS -CoV2, however, there is a reduced experience identified with Hispanic or Latino patients [1]. We would like to share our experience with liver transplantation and SARS-CoV-2 infection (Real-time PCR identification) during 2020.

Objectives

Describe the main infectious complications identified in patients with SARS-CoV2 and liver transplantation.

Identify mortality rate among this group of patients and answer to therapies provided during their stay at the Hospital.

Compare the mortality rate with other studies without Latin patients or with a reduced presence of them.

Methods

This is an observational descriptive study carried out from May to August 2020

Results

14 Hispanic patients were admitted to our institution (mean age 64 years; range: 57-76). Nine patients required hospitalization, and four patients were admitted to the intensive care unit (ICU). The most frequent risk factors were a history of arterial hypertension (n=8) and chronic kidney disease (n=6). The immunosuppression of these patients was based on antimetabolites (n = 9), calcineurin (n = 8), prednisolone (n = 4) and everolimus (n = 3). The onset of symptoms was six days approximately.

All ICU patients receiving mechanical ventilation and renal replacement therapy for stage 3 acute renal failures. However, bacteremia caused by E. Coli, Citrobacter spp., and Staphylococcus aureus was present in three patients, an outcome that was not identified in the study population. The mortality rate was 28.5%. The mortality rate was higher than Webb et al 1 (18%) and other studies where rates were reported from 12% to 18%, and where the white population was predominant.

The therapy provided in our institution was focused on tapering the immunosuppressive therapy attached with the use of dexamethasone. This treatment was given to six patients [4].

Conclusion

Our rate of mortality was higher compared with other similar studies. However, further future studies should include outcomes in the Hispanic population due to the social factors in addition to genetic factors that could be involved in higher mortality in ICU. Also, taking into account the increase in the number of cases, the follow-up of patients with liver diseases by telephone contact with transplant centers should be considered.

Uncited references

[2,3,5]