Fatal decisions: Delaying liver transplant due to Covid claims many

Hyderabad: Nearly 50 per cent patients in need of early liver transplant, but who did not undergo the procedure due to fear of contracting Covid-19 or due to testing positive just before the transplant surgery, died in 2020, doctors said.

According to the transplant team at the Gleneagles Global Hospitals in Lakdikapul, during the Covid-19 lockdown and in the subsequent months, 48 patients needed to undergo liver transplant.

Twenty-three patients were under regular medical supervision; they didn't contract the Covid-19 infection and underwent successful liver transplantation. Seven patients, despite Covid-19 infection, successfully underwent liver transplant and survived.

The doctors said that 13 patients died after delaying the procedure due to the fear of contracting the deadly virus or for associated reasons. The remaining five patients, though prepared for liver transplant surgery, but got infected with Covid-19 and died in the pre-transplant stage. The main reason for the deaths is delay in transplant surgery, rather than Covid-19 infection itself, they said.

"When the condition of liver worsens, transplant is the only option before a patient. Any delay in undergoing transplant could be fatal. These patients and their family members delayed the procedure due to the fear of contracting coronavirus or other related reasons. This delay proved costly for the victims who did not survive. It is important that people do not delay transplant when liver condition worsens," said Raghavendra Babu, clinical head and senior consultant liver transplant surgeon, of the hospital.

"Between June and December last year, we performed 30 liver transplant procedures at the Gleneagles Global Hospitals, with 100 per cent success rate. Among these, seven recipients and three live donors were Covid-19 positive; and in two instances, both donors and recipients were found positive for Coronavirus. Hence, it is important for people to note that liver transplant can be performed on patients who are cured of the Covid-19 virus," added Babu.

Clinical features of Covid-19 patients are highly diverse from pulmonary symptoms to neurological manifestations. Coronavirus positive patients admitted to hospitals have increased liver enzymes as a common problem, yet it can be rectified. Post-liver transplant, patients with mild to moderate Covid-19 symptoms are recommended to continue with immunosuppression medication. Considering these aspects, the patients must not delay liver transplant surgery in case doctors recommend it to be performed immediately.