Dr Ravi Mohanka, Consultant and Chief – HBP Surgery and Liver Transplant, Global Hospital, Mumbai

Mumbai : Patients who have undergone a liver transplant are on immunosuppressive medicines and may have a higher risk of infections such as COVID-19. During the pandemic, they should be under strict lockdown avoiding contact with any person who might have the infection. Patients may have a lot of free time during the lockdown and should identify productive activities to keep themselves occupied indoors such as pursuing their hobby (painting, reading, etc.). Patients and their family members should strictly avoid smoking as it can be dangerous in case of COVID-19 infection. There should be no alcohol intake as it can suddenly cause severe injury in the transplanted liver.

Patients should however continue taking their medicines and if their availability is a problem contact their transplant team immediately as skipping these medicines for any reason can cause rejection. Most transplant teams offer tele-consultation which could be utilized to review your progress with them. If they suffer from another disease, tele-consultation with other appropriate specialist doctors should also be continued. If patients need a procedure or surgery, the same should be planned only after the lockdown period. However, any emergency procedure can be carried out after testing and being found to the negative for COVID infection.

During the COVID-19 pandemic, they should limit their movement in the community and exposure to other sick patients as patients. If they need to travel out their house they should wear a N-95 mask and avoid touching outside surfaces and may even use a glove. The glove should be discarded after they return home. Patients should avoid starting a new medicine during this period and in case of any symptoms, even if not related to the liver disease or transplant, immediately contact their transplant team. There is currently no proven vaccine to prevent or antiviral medicine to treat this infection, but keep Hydroxychloroquine, Azithromycin and Paracetamol available with you, in case your doctor prescribes the same. In case of high-grade fever, dry cough or sputum production, they should be seen immediately and tested for suspected infection by a pulmonologist (lungs specialist) and an infection disease (ID) specialist keeping the liver specialist informed of all progress. While being treated for the infection, the condition of their liver disease should be closely monitored by the transplant team.