新型冠状病毒感染下肝移植的研究现状

Current research in liver transplantation during the Covid-19 pandemic

由新型冠状病毒感染引起的新型冠状病毒肺炎改变了人类的日常生活和临床诊疗行为。因疫情下肝移植数量锐减及病毒导致的肝功能损害,使肝移植等待者的预后更差。肝移植受者长期接受免疫抑制治疗,其感染风险高于一般人群。虽然部分研究者认为免疫抑制治疗对感染者具有保护作用,但易引起慢性感染。出于对病毒传播风险的担忧,现有专家共识不建议使用具有新型冠状病毒感染史的供肝,但目前已发表的研究未发现病毒可经供肝传播至受者。因此,关于新型冠状病毒感染供肝的应用仍存在争议。本文就新型冠状病毒感染下肝移植的研究现况及进展进行综述,以期为未来的肝移植实践提供新思路。

The coronavirus disease(Covid-19)pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has drastically changed our daily life and clinical practice.Due to the reduction of liver transplantation and the liver injury caused by SARS-CoV-2 infection during the pandemic,the prognosis of waitinglisted liver transplant candidates is worse.Due to the long-term immunosuppressive therapy of liver recipients,their risk of infection is higher than the general population.Although some studies suggested that immunosuppressive therapy seems to have a protective effect in infected patients,it also leads to chronic infection.Due to the concerns about the risk of virus transmission,expert consensus does not recommend the utilization of donor livers with the history of Covid-19.Currently,published articles do not support the argument that virus can be transmitted to recipients through donor livers.Therefore,the feasibility of liver transplantation utilizing donor livers with SARS-CoV-2 infection remains controversial.In this article,current advances in liver transplantation during the Covid-19 pandemic are reviewed to provide a new perspective for liver transplantation in the future.