Impact of COVID-19 on liver transplantation in Europe: alert from an early survey of European Liver and Intestine Transplantation Association and European Liver Transplant Registry

Transpl Int. 2020 Oct;33(10):1244-1252. doi: 10.1111/tri.13680. Epub 2020 Aug 13.


There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR). One hundred nine out of 149 (73%) of ELTR centers located in 28 European countries (93%) responded. Ninety-four (86%) of the centers tested all donors, and 75 (69%) centers tested all LT recipients for SARS-CoV-2. Seventy-three (67%) centers selected recipients for LT in the COVID-19 pandemic, whereas 33% did not. Eighty-eight centers reported COVID-19 infection in 57 LT candidates and in 272 LT recipients. Overall crude incidence of COVID-19 among LT candidates and recipients was estimated 1.05% (range 0.5-20%) and 0.34% (range 0.1-4.8%), respectively, and it was significantly higher among candidates (P < 0.001). Crude rate of death was 18% (10/57) among candidates and 15% (36/244) among recipients. This first large-scale European snapshot study clearly shows that both LT candidates and recipients are at a high risk for COVID-19. These results plead for an early and pro-active screening of COVID-19 symptoms in these populations.

Keywords: COVID-19; SARS-CoV-2; liver recipient; liver transplantation; mortality; survey.

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 Testing
  • Comorbidity
  • Donor Selection / standards
  • Early Diagnosis
  • Europe / epidemiology
  • Health Care Surveys
  • Humans
  • Immunocompromised Host
  • Incidence
  • Liver Diseases / epidemiology*
  • Liver Diseases / surgery
  • Liver Transplantation / statistics & numerical data*
  • Mass Screening
  • Pandemics*
  • Postoperative Complications / epidemiology
  • Procedures and Techniques Utilization
  • Registries
  • Risk
  • SARS-CoV-2*
  • Tissue Donors / statistics & numerical data
  • Transplant Recipients / statistics & numerical data