Liver Transplant Society of India releases guidelines for transplant amid COVID-19

The Liver Transplant Society of India (LTSI) has released guidelines for issues specific to the organ transplant, saying the COVID-19 outbreak in India is likely going to get prolonged and will impact patients in need of liver transplants.

According to guidelines put up on the Indian Council of Medical Research's (ICMR) website, acute liver failure can be done as usual after medical therapy fails and elective deceased donor liver transplant should be done only if the donor is COVID-19 negative.

"As the current situation is not ideal for liver transplantation, it should be done cautiously in selected situations. Immunocompromised patients are at a greater risk and there is an immediate need of guidelines for liver transplantation in India, both in deceased donor Liver Transplant and living donor liver transplant centres.

"Also, healthcare transmission of COVID-19 have occurred and given the potential for greater infectivity, strict isolation precautions should be followed for anyone with suspected SARS-CoV2," the LTSI said.

The current situation is not appropriate for routine living donor liver transplant activity. Transplants for acute liver failure as well for acute on chronic liver failure with organ failure can be done. For other cases, the urgency of liver transplants to be decided by the individual centers on case-by-case basis," it said.

The guidelines stated that all donors and recipients must undergo testing for COVID-19. Liver transplant should only be carried out if both donor and recipient test negative.

If donor or recipient tests positive, then the transplant should be put on hold. Subsequently, it can be carried out if they test negative on two consecutive tests, and are declared clear of the COVID-19 infection, it stated, adding in view of the rapidly changing scenario of COVID-19 infection in India, these guidelines may be revised and updated accordingly.

The death toll due to coronavirus rose to 242 and the number of cases in the country climbed to 7,529 on Saturday, an increase of 768 cases in 24 hours since Friday evening, according to the Union Health Ministry.

However, a PTI tally of figures reported by various states as on Saturday showed at least 8,016 cases and 261 deaths.

There has been a lag in the Union Health Ministry figures, compared to the number of cases announced by different states, which officials attribute to procedural delays in assigning the cases to individual states.