Challenges of continuation of live liver donor programme during COVID-19 pandemic in Pakistan: outcomes and lessons learned

Background COVID-19 pandemic has globally affected healthcare including the transplantation programmes.Materials and methods We retrospectively studied the impact of COVID-19 on live liver donor (LLD) programme at liver transplant centre in Gambat, Pakistan. Standard operative procedures (SOPs) incl...

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Main Authors: Azhar Hussain, Bilal Ahmed, Abdul Wahab Dogar, Shams Uddin, Syed Hasnain Abbas, Hala Izzo, Kaleem Ullah, Azam Shoaib, Siraj Ud Din, Muhammad Ameer Hamza, Munaza Zafar, Muhammad Affan Qaiser, Hamid Raza, Muhammad Asif Baig, Ali Husnain, Khalid Mumtaz
Format: Article
Language:English
Published: BMJ Publishing Group 2021-10-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/8/1/e000723.full
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Summary:Background COVID-19 pandemic has globally affected healthcare including the transplantation programmes.Materials and methods We retrospectively studied the impact of COVID-19 on live liver donor (LLD) programme at liver transplant centre in Gambat, Pakistan. Standard operative procedures (SOPs) including COVID-19 nasopharyngeal swab PCR, CT scans, personal protective equipment use, 6-feet distancing were developed for LLD and transplant team to mitigate COVID-19 exposure. We compared the complications, healthcare utilisation (hospital stay, readmission) and mortality between two LLD cohorts—before and during COVID-19 pandemic from March 2019 to December 2020.Results During study period 300 LLD surgeries were performed. There was an increase in rate of LLDs from 132 (44%) in pre-COVID to 168 (56%) during COVID-19 era. Average numbers of transplants per month performed during pre-COVID and during COVID-19 era were 10.1 and 14, respectively. No donor has developed COVID-19 infection during hospitalisation. Rate of all LLD complications (32 (21.47%) and 49 (29.16%), p=0.43), uneventful discharges (120/168 (71.4%) and 88/132 (66.6%), p<0.05), mean hospital stay (6±2 days and 5±2 days, p=0.17) and readmission (5 (4%) and 3 (1.8%), p=0.43) were similar during the pre-COVID and COVID-19 era. No donor mortality was observed during study period.Conclusion With the implementation of mindful SOPs, rate of LLD increased without any case of COVID-19 infection. Our SOPs were helpful in continuation of LLD programme in a developing country during COVID-19 pandemic.
ISSN:2054-4774