Liver transplantation in Italy in the era of COVID 19: reorganizing critical care of recipients
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Liver transplantation in Italy in the era of COVID 19: reorganizing critical care of recipients Antonio Siniscalchi1 · Giovanni Vitale1 · Maria Cristina Morelli1 · Matteo Ravaioli1 · Cristiana Laici1 · Amedeo Bianchini1 · Massimo Del Gaudio1 · Fabio Conti2 · Luca Vizioli1 · Matteo Cescon1 Received: 2 June 2020 / Accepted: 13 September 2020 © Società Italiana di Medicina Interna (SIMI) 2020
Abstract Transplant programs have been severely disrupted by the COVID-19 pandemic. Italy was one of the first countries with the highest number of deaths in the world due to SARS-CoV-2. Here we propose a management model for the reorganization of liver transplant (LT) activities and policies in a local intensive care unit (ICU) assigned to liver transplantation affected by restrictions on mobility and availability of donors and recipients as well as health personnel and beds. We describe the solutions implemented to continue transplantation activities throughout a given pandemic: management of donors and recipients’ LT program, ICU rearrangement, healthcare personnel training and monitoring to minimize mortality rates of patients on the waiting list. Transplantation activities from February 22, 2020, the data of first known COVID-19 case in Italy’s Emilia Romagna region to June 30, 2020, were compared with the corresponding period in 2019. During the 2020 study period, 38 LTs were performed, whereas 41 were performed in 2019. Patients transplanted during the COVID-19 pandemic had higher MELD and MELD-Na scores, cold ischaemia times, and hospitalization rates (p
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