Ann Hepatobiliary Pancreat Surg.  2020 Nov;24(4):526-532. 10.14701/ahbps.2020.24.4.526.

Convalescent plasma therapy and remdesivir duo successfully salvaged an early liver transplant recipient with severe COVID-19 pneumonia

• Jamir I
• Lohia P
• Pande RK
• Setia R
• Singhal AK
• Chaudhary A

• KMID: 2508864
• DOI: http://doi.org/10.14701/ahbps.2020.24.4.526

Abstract

The impact and clinical spectrum of COVID-19 infection in liver transplant recipients/solid organ transplants are being unveiled during this recent pandemic. The clinical experience of use of current antiviral drugs and immunomodulators are sparse in solid organ transplantation. We present the clinical course of a 49-year-old male recipient who underwent living donor liver transplant for recurrent gastrointestinal bleed and contracted severe COVID-19 pneumonia during the third postoperative week. Herein we report the successful management of severe COVID-19 pneumonia using convalescent plasma therapy and remdesivir. Recipient’s clinical deterioration was halted after three consecutive convalescent plasma transfusions with improvement in hypoxia and inflammatory markers (interleukin-6 and C-reactive protein). The use of convalescent plasma therapy along with remdesivir may be an ideal combination in the management of severe COVID-19 pneumonia in solid organ transplant recipients.

Keyword

COVID-19; Convalescent plasma therapy; Remdesivir; CRP; CRS; RT-PCR; Liver transplant

Figure

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  Fig. 1 AST, ALT and total bilirubin values during the hospital course.

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  Fig. 2 Clinical course and management timeline during severe COVID-19 pneumonia.

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  Fig. 3 Serial chest X-rays showing gradual resolution of lung opacities.

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  Fig. 4 Changes in the levels of inflammatory markers after treatment with convalescent plasma therapy and remdesivir duo.

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