Restarting LDLT during COVID-19: Early results after restructuring

Abstract Introduction LDLT have been mostly suspended and DDLT activity has been considerably reduced due to COVID-19. We modified our protocols and procedure in line with the COVID-19 guidelines. Following the restructuring, we have performed 20 LDLT’s. Our study reports on outcomes of these cases and demonstrates the feasibility of LDLT during this pandemic. Material & Method The changes were influenced by experiences and communications from across the globe. About a month of self-imposed moratorium was spent in restructuring the program and implementing new protocols. 20LDLT’s were performed between 18thApril to 15th September under new protocols. Our experience includes 2 simultaneous liver-kidney transplant,1 ABO-incompatible LDLT and 1 paediatric case(11 months). Result All the patient recovered successfully barring one mortality. We maintained our post-operative immunosuppression protocol without much changes. Major complications were seen in 30% recipients but none of the donors. One recipient was infected with COVID19 during post-operative period. A donor-recipient couple contracted COVID19 after discharge from the hospital. All of them recovered from their COVID19 illness and liver enzymes were unaffected. Conclusion This represents a microcosm of experience in LDLT during COVID-19 era. Outcomes of LDLT are not affected by COVID-19 per se, provided we make necessary changes.