*Purpose: Data on mortality and immunosuppression role regarding Liver transplant recipients affected by COVID-19 are still under debate. The present study identified risk factors for mortality and the role of immunosuppression in COVID-19 liver transplant recipients.

*Methods: A systematic review about SARS-CoV-2 infection in liver transplant recipients was performed. The primary outcomes were risk factors of mortality and the role of immunosuppression. A meta-analysis was not performed as there was different metric of the same outcome (mortality).

*Results: An overall 1.110 LT recipients of 1.810 SOT were included and data on mortality were available for 1.110 liver transplant recipients with SARS-CoV-2 infection. The mortality rate ranged between 0-37%. Risk factors of mortality were age>60, Mofetil Mycophenolate use, extra-hepatic solid tumor, Charlson Comorbidity Index, male sex, dyspnoea at diagnosis, higher baseline serum creatinine, congestive heart failure, chronic lung disease, chronic kidney disease, diabetes, BMI>30. Tacrolimus was identified as a protective factor for mortality.

*Conclusions: Liver transplant patients present additional risk factors of mortality related to immunosuppression. Immunosuppression’s role in the progression to severe infection and mortality may correlate with different drugs. The present research suggests a safe use of Tacrolimus during the COVID-19 pandemic and highlights the need for further studies about post-transplant immunosuppression in patients at high risk of mortality.

« Back to 2022 American Transplant Congress