Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2020; 26(22): 2987-2999
Published online Jun 14, 2020. doi: 10.3748/wjg.v26.i22.2987
COVID-19 pandemic: Its impact on liver disease and liver transplantation
Tevfik Tolga Sahin, Sami Akbulut, Sezai Yilmaz
Tevfik Tolga Sahin, Sami Akbulut, Sezai Yilmaz, Deaprtment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 244280, Turkey
Author contributions: Akbulut S and Sahin TT conceived the project and designed research; all authors wrote the manuscript and reviewed final version.
Conflict-of-interest statement: The authors declare no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sami Akbulut, MD, Associate Professor, Deaprtment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10. Km, Malatya 44280, Turkey.
Received: May 7, 2020
Peer-review started: May 7, 2020
First decision: May 15, 2020
Revised: May 23, 2020
Accepted: June 9, 2020
Article in press: June 9, 2020
Published online: June 14, 2020

Severe pulmonary disease caused by the novel coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)], has devastated many countries around the world. It has overwhelmed the medical system. The priorities of many institutions have changed to manage critically ill corona virus infectious disease-2019 (COVID-19) patients, which affected the working style of many departments. Hepatologists and transplant surgeons look after a very sensitive patient group. Patients with liver disease need special attention and continuous follow-up. Similarly, transplant candidates also need special care. Healthcare professionals in the field of hepatology face the overwhelming task of taking care of COVID-19 patients with hepatic complications, liver disease or transplant patients who are SARS-CoV-2 positive, and the patients on routine surveillance who do not have COVID-19. This review will evaluate COVID-19 from the perspective of its effect on the liver and its possible effects on patients with liver disease. Furthermore, the level of care for liver transplant recipients during the pandemic will be discussed.

Keywords: SARS-Cov-2, COVID-19, Acute liver injury, Chronic liver disease, Liver transplantation, Risk factors

Core tip: Data regarding the effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on liver transplant (LT) recipients are very limited. We have performed 35 living donor liver transplantations since the first corona virus infectious disease-2019 (COVID-19) case was observed in Turkey. We routinely test living liver donors and recipients for SARS-CoV-2 with nasopharyngeal swabs before the liver transplantation procedure. Furthermore, we repeated this test before discharging the patients. We have not found any SARS-CoV-2-positive LT recipients or donors, nor have we found any patients with COVID-19-like pneumonia. We have limited the number of patients going to the outpatient clinic, and only performed LT when it was urgently needed. We took the necessary precautions to protect the healthcare personnel by limiting the duration of work and providing protective equipment to all, including inpatients.