Convalescent Plasma Therapy and Remdesivir Duo Successfully Salvaged an Early Liver Transplant Recipient with Severe COVID-19 Pneumonia

Overview

Journal Ann Hepatobiliary Pancreat Surg

Date 2020 Nov 25

PMID 33234758

Citations 10

Authors

Imtiakum Jamir

Pankaj Lohia

Rajesh Kumar Pande

Rasika Setia

Amit Kumar Singhal

Abhideep Chaudhary

Affiliations

Soon will be listed here.

Abstract

The impact and clinical spectrum of COVID-19 infection in liver transplant recipients/solid organ transplants are being unveiled during this recent pandemic. The clinical experience of use of current antiviral drugs and immunomodulators are sparse in solid organ transplantation. We present the clinical course of a 49-year-old male recipient who underwent living donor liver transplant for recurrent gastrointestinal bleed and contracted severe COVID-19 pneumonia during the third postoperative week. Herein we report the successful management of severe COVID-19 pneumonia using convalescent plasma therapy and remdesivir. Recipient's clinical deterioration was halted after three consecutive convalescent plasma transfusions with improvement in hypoxia and inflammatory markers (interleukin-6 and C-reactive protein). The use of convalescent plasma therapy along with remdesivir may be an ideal combination in the management of severe COVID-19 pneumonia in solid organ transplant recipients.

Citing Articles

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References

Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J . Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. 2020; 323(16):1582-1589. PMC: 7101507. DOI: 10.1001/jama.2020.4783. View

Wolfel R, Corman V, Guggemos W, Seilmaier M, Zange S, Muller M . Virological assessment of hospitalized patients with COVID-2019. Nature. 2020; 581(7809):465-469. DOI: 10.1038/s41586-020-2196-x. View

Psaltopoulou T, Sergentanis T, Pappa V, Politou M, Terpos E, Tsiodras S . The Emerging Role of Convalescent Plasma in the Treatment of COVID-19. Hemasphere. 2020; 4(3):e409. PMC: 7306310. DOI: 10.1097/HS9.0000000000000409. View

Tanaka Y, Sato Y, Sasaki T . Suppression of coronavirus replication by cyclophilin inhibitors. Viruses. 2013; 5(5):1250-60. PMC: 3712306. DOI: 10.3390/v5051250. View

Saigal S, Gupta S, Sudhindran S, Goyal N, Rastogi A, Jacob M . Liver transplantation and COVID-19 (Coronavirus) infection: guidelines of the liver transplant Society of India (LTSI). Hepatol Int. 2020; 14(4):429-431. PMC: 7140588. DOI: 10.1007/s12072-020-10041-1. View

Liu B, Wang Y, Zhao Y, Shi H, Zeng F, Chen Z . Successful treatment of severe COVID-19 pneumonia in a liver transplant recipient. Am J Transplant. 2020; 20(7):1891-1895. PMC: 9800465. DOI: 10.1111/ajt.15901. View

Bikdeli B, Madhavan M, Jimenez D, Chuich T, Dreyfus I, Driggin E . COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020; 75(23):2950-2973. PMC: 7164881. DOI: 10.1016/j.jacc.2020.04.031. View

Jiang J, Miao Y, Zhao Y, Lu X, Zhou P, Zhou X . Convalescent plasma therapy: Helpful treatment of COVID-19 in a kidney transplant recipient presenting with severe clinical manifestations and complex complications. Clin Transplant. 2020; 34(9):e14025. PMC: 7361058. DOI: 10.1111/ctr.14025. View

Beigel J, Tomashek K, Dodd L, Mehta A, Zingman B, Kalil A . Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020; 383(19):1813-1826. PMC: 7262788. DOI: 10.1056/NEJMoa2007764. View

10.

Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A . Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med. 2020; 382(24):2327-2336. PMC: 7169476. DOI: 10.1056/NEJMoa2007016. View

11.

Hammami M, Garibaldi B, Shah P, Liu G, Jain T, Chen P . Clinical course of COVID-19 in a liver transplant recipient on hemodialysis and response to tocilizumab therapy: A case report. Am J Transplant. 2020; 20(8):2254-2259. PMC: 7267667. DOI: 10.1111/ajt.15985. View

12.

Schmidt-Arras D, Rose-John S . IL-6 pathway in the liver: From physiopathology to therapy. J Hepatol. 2016; 64(6):1403-15. DOI: 10.1016/j.jhep.2016.02.004. View

13.

Qin J, Wang H, Qin X, Zhang P, Zhu L, Cai J . Perioperative Presentation of COVID-19 Disease in a Liver Transplant Recipient. Hepatology. 2020; 72(4):1491-1493. DOI: 10.1002/hep.31257. View

14.

Fix O, Hameed B, Fontana R, Kwok R, McGuire B, Mulligan D . Clinical Best Practice Advice for Hepatology and Liver Transplant Providers During the COVID-19 Pandemic: AASLD Expert Panel Consensus Statement. Hepatology. 2020; 72(1):287-304. PMC: 7262242. DOI: 10.1002/hep.31281. View

15.

Ye M, Fu D, Ren Y, Wang F, Wang D, Zhang F . Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol. 2020; 92(10):1890-1901. PMC: 7262027. DOI: 10.1002/jmv.25882. View

16.

Salazar E, Perez K, Ashraf M, Chen J, Castillo B, Christensen P . Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma. Am J Pathol. 2020; 190(8):1680-1690. PMC: 7251400. DOI: 10.1016/j.ajpath.2020.05.014. View

17.

Horby P, Lim W, Emberson J, Mafham M, Bell J, Linsell L . Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2020; 384(8):693-704. PMC: 7383595. DOI: 10.1056/NEJMoa2021436. View

18.

Pereira M, Mohan S, Cohen D, Husain S, Dube G, Ratner L . COVID-19 in solid organ transplant recipients: Initial report from the US epicenter. Am J Transplant. 2020; 20(7):1800-1808. PMC: 7264777. DOI: 10.1111/ajt.15941. View