**Presented at the 2022 CMSA Annual Conference**
*** RN, CCM Ethics and SW credits ***
The coronavirus COVID-19 pandemic resembles a blockbuster horror movie. The effects of COVID-19 on the liver have been dramatic. The main causes of liver damage from COVID-19 are direct viral aggression, coagulation dysfunction, endothelial damage, drug toxicity related to COVID-19 therapy, acute inflammatory damage, and hypoxia caused by pneumonia. In addition, alcohol consumption has increased during the pandemic. Research published in the Journal of the American Medical Association found that the number of people who were placed on a liver transplant waiting list or who got a liver transplant due to alcoholic hepatitis was 50 percent higher than what was expected based on pre-pandemic trends. According to United Network for Organ Sharing (UNOS), approximately 8,000 liver transplants are performed every year in the United States. During the first 10 months of the pandemic, waiting list registrations and liver transplants increased by more than 50 percent, compared with the forecasted numbers before COVID-19. The World Journal of Clinical Cases reported that nonalcoholic fatty liver disease (NAFLD) is affecting a quarter of the world's population and 2-11% of patients with chronic liver disease who have had COVID-19. Patients with obesity, diabetes mellitus and hypertension are frequently associated with NAFLD and are at high risk for COVID-19. People with impaired liver function develop more severe forms of COVID-19. Is the need for liver transplantation going to increase? We hope this presentation brings awareness of the serious issue of COVID-19 related liver issues. Case managers and social workers are front line health care providers and can have a huge impact by identifying, referring, and facilitating treatment for victims of COVID-19 with liver involvement. In this presentation, we will give an overview of the organ transplantation process starting with diagnosis and evaluation through post operative hospital care, “live” donors versus “cadaver” donors, the effects of COVID-19 on the liver, projections of future effects of COVID-19 on the liver and liver transplants, and ethical implications related to the transplant process.
OBJECTIVES:
- Describe the organ transplant process from diagnosis through post operative hospital care.
- Discuss the effects of COVID-19 on the liver.
- Explain the difference between a “love” donor and a “cadaver” donor.