Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jan 18, 2023; 13(1): 1-9
Published online Jan 18, 2023. doi: 10.5500/wjt.v13.i1.1
COVID-19 in liver transplant patients: Impact and considerations
Shrouq Khazaaleh, Mohammad Alomari, Sanskriti Sharma, Nikhil Kapila, Xaralambos Bobby Zervos, Adalberto Jose Gonzalez
Shrouq Khazaaleh, Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH 44126, United States
Mohammad Alomari, Nikhil Kapila, Xaralambos Bobby Zervos, Adalberto Jose Gonzalez, Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL 33331, United States
Sanskriti Sharma, Department of Internal Medicine, WellStar Atlanta Medical Center, Atlanta, GA 30312, United States
Author contributions: Khazaaleh S, Alomari M, Sharma S, Kapila N, Zervos XB, and Gonzalez AJ contributed to the article design, writing, proofreading, and revision.
Conflict-of-interest statement: The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript, and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication.
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: Adalberto Jose Gonzalez, MD, Assistant Professor, Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States.
Received: September 13, 2022
Peer-review started: September 13, 2022
First decision: October 20, 2022
Revised: November 4, 2022
Accepted: December 13, 2022
Article in press: December 13, 2022
Published online: January 18, 2023

The coronavirus disease 2019 pandemic has significantly impacted liver transplantation worldwide, leading to major effects on the transplant process, including the pretransplant, perioperative, and post-transplant periods. It is believed that patients with chronic liver disease, especially those with cirrhosis, have a higher risk of complications from coronavirus disease 2019 infection compared to the general population. However, evaluation of coronavirus disease 2019 effects on liver transplant patients has not uniformly demonstrated worse outcomes. Nonetheless, the pandemic created significant challenges and restrictions on transplant policies and organ allocation.

Keywords: COVID-19, Liver transplantation, Immunosuppression, Living donor, Mortality

Core Tip: The coronavirus disease 2019 pandemic exerted significant challenges to the liver transplant structure worldwide, initially resulting in a decline in liver transplants but soon after rebounded. A better understanding of this infection together with robust guidance by the international transplant societies helped offset this decline. A multitude of considerations should be exercised throughout the liver transplant process to maintain acceptable safety and outcomes.