Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity...Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(<1 year)vs.late(>1 year)post-transplant period.Methods:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.Results:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant.The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days.Fever and malaise were the common presenting symptoms.The most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe groups.Except for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe group.Eight(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft rejection.In recipients with early vs.late post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and death.Conclusion:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.展开更多
Background and aims:GM(General-Motors)diet is a low-calorie 7-day diet plan using complex carbohydrates used for quick weight loss.Dietary optimisation is known to decrease steatosis and improve outcomes in liver dono...Background and aims:GM(General-Motors)diet is a low-calorie 7-day diet plan using complex carbohydrates used for quick weight loss.Dietary optimisation is known to decrease steatosis and improve outcomes in liver donors.We evaluated the efficacy and feasibility of using GM diet in steatotic live liver donors(LLD).Methods:LLDs who either had BMI>30 kg/m^(2),Computerised tomography liver attenuation index(CT-LAI)<0 HU,Magnetic resonance(MR)fat-fraction of>10%were started on GM diet for 1 week.Records of these LLDs and their recipients were retrieved retrospectively and analysed.Weight,liver function tests(LFT),MR fat-frac-tion,CT-LAI,hospital-stay and complications were analysed in LLDs while early graft dysfunction(EGD)and complications were assessed in recipients.Results:A total of 51 LLDs with mean age of 34.6?9.5 years with baseline mean weight of 80.6±10.8 kg and BMI of 29.1±2.78 kg/m^(2) were started on GM diet.After a week of following the GM diet,there was an average weight loss of 3.46±2.1 kg,a decrease in fat-fraction by 3.8%±2.7,and an improvement in CT-LAI by 6.7?3.7 HU.All patients could successfully undergo donor hepatectomy with an average postoperative ICU stay of 2.86±0.8 days and hospital stay of 6.82?0.81 days.No donor had steatosis>10% on intraoperative Tru-cut biopsy and their post-operative outcomes were similar to normal liver donors.There were intra-abdominal collections in 2 donors requiring drainage and one required re-exploration for intestinal obstruction.There was EGD in 8 recipients(15.6%)and mortality in 1(1.9%)recipients.Conclusion:GM diet is safe and effective regimen to reduce steatosis and increase healthy LLD pool without compromising donor or recipient safety.展开更多
文摘Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services globally.The aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(<1 year)vs.late(>1 year)post-transplant period.Methods:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February 2021.Results:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of transplant.The overall median interval between transplantation and COVID-19 diagnosis was 816.00 days.Fever and malaise were the common presenting symptoms.The most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe groups.Except for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe group.Eight(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft rejection.In recipients with early vs.late post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and death.Conclusion:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.
文摘Background and aims:GM(General-Motors)diet is a low-calorie 7-day diet plan using complex carbohydrates used for quick weight loss.Dietary optimisation is known to decrease steatosis and improve outcomes in liver donors.We evaluated the efficacy and feasibility of using GM diet in steatotic live liver donors(LLD).Methods:LLDs who either had BMI>30 kg/m^(2),Computerised tomography liver attenuation index(CT-LAI)<0 HU,Magnetic resonance(MR)fat-fraction of>10%were started on GM diet for 1 week.Records of these LLDs and their recipients were retrieved retrospectively and analysed.Weight,liver function tests(LFT),MR fat-frac-tion,CT-LAI,hospital-stay and complications were analysed in LLDs while early graft dysfunction(EGD)and complications were assessed in recipients.Results:A total of 51 LLDs with mean age of 34.6?9.5 years with baseline mean weight of 80.6±10.8 kg and BMI of 29.1±2.78 kg/m^(2) were started on GM diet.After a week of following the GM diet,there was an average weight loss of 3.46±2.1 kg,a decrease in fat-fraction by 3.8%±2.7,and an improvement in CT-LAI by 6.7?3.7 HU.All patients could successfully undergo donor hepatectomy with an average postoperative ICU stay of 2.86±0.8 days and hospital stay of 6.82?0.81 days.No donor had steatosis>10% on intraoperative Tru-cut biopsy and their post-operative outcomes were similar to normal liver donors.There were intra-abdominal collections in 2 donors requiring drainage and one required re-exploration for intestinal obstruction.There was EGD in 8 recipients(15.6%)and mortality in 1(1.9%)recipients.Conclusion:GM diet is safe and effective regimen to reduce steatosis and increase healthy LLD pool without compromising donor or recipient safety.
