COVID-19–Associated Hepatitis Complicating Recent Living Donor Liver Transplantation Article Swipe

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Medicine Biliary atresia Liver biopsy Liver transplantation Hepatitis Liver function tests Gastroenterology Liver function Acute hepatitis Pathology Immunology Biopsy Internal medicine Transplantation

Stephen M. Lagana , Simona De Michele , Michael J. Lee , Jean C. Emond , Adam Griesemer , Sheryl Tulin‐Silver , Elizabeth C. Verna , Mercedes Martínez , Jay H. Lefkowitch ·

YOU? · · 2020 · Open Access · · DOI: https://doi.org/10.5858/arpa.2020-0186-sa · OA: W3016387161

We present a case of COVID-19 hepatitis in a living donor liver allograft recipient whose donor subsequently tested positive for COVID-19. The patient is a female infant with biliary atresia (failed Kasai procedure). She recovered well, with improving liver function tests for 4 days. On postoperative day 4 the patient developed respiratory distress and fever. COVID-19 testing (polymerase chain reaction) was positive. Liver function test results increased approximately 5-fold. Liver biopsy showed moderate acute hepatitis with prominent clusters of apoptotic hepatocytes and associated cellular debris. Lobular lymphohistiocytic inflammation was noted. Typical portal features of mild to moderate acute cellular rejection were also noted.