Our experiences of COVID-19 in pediatric liver transplant recipients

Abstract

We retrospectively studied the frequency and clinical outcome of SARS-CoV-2 infection, and treatment, including the management of immunosuppressive agents in pediatric liver transplant (LT) recipients. Among 708 pediatric patients who underwent LT at our hospital between November 2005 and December 2022, PCR tests confirmed 125 recipients (17.7%) with SARS-CoV-2 infection and one case during the operation. One hundred nineteen (95.2%) patients had positive results after January 2022 during the omicron surge. Regarding the severity, 124 patients (99.2%) were categorized as asymptomatic or mild infection, and no patient required mechanical ventilation. In the meantime, one patient developed an acute cellular rejection (ACR) 14 days after reducing the immunosuppressant. SARS-CoV-2 infection did not lead to severe disease in the pediatric LT recipients in this study. Therefore, aggressive reduction of immunosuppression does not seem necessary and the attention should be paid so not to provoke ACR when immunosuppressive drugs are titrated due to SARS-CoV-2 infection.