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Am J Transplant. 2020 Apr 13. doi: 10.1111/ajt.15928. [Epub ahead of print]
Clinical characteristics and immunosuppressants management of coronavirus disease 2019 in solid organ transplant recipients.
Zhong Z1, Zhang Q1, Xia H1, Wang A2, Liang W1, Zhou W1, Zhou L1, Liu X2, Rao L2, Li Z3, Peng Z3, Mo P4, Xiong Y4, Shaojun Y1, Wang Y1, Ye Q1.
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Abstract
Over 1,000,000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 nine days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.
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KEYWORDS:
COVID-19; Clinical characteristics; Immunosuppressant; Solid organ transplant recipient
PMID:32282986DOI:10.1111/ajt.15928