Liver transplantation for post-COVID-19 cholangiopathy: Report of 2 cases

Abstract

Post-Covid-19 cholangiopathy is a rare disease characterized by chronic cholestasis, that typically appears after resolution of the covid-19 virus infection. The pathophysiology is not fully understood, and prognosis in severe cases remains poor with liver transplantation remaining the only curative treatment option. We present two patients who developed post-covid-19 cholangiopathy after prolonged intensive care unit stay due to severe COVID-19 pneumonia. Both patients required invasive ventilation for more than a month. After adequate recovery from respiratory failure, the patients developed severe cholestatic jaundice and liver failure. The patients had not history of previous liver disease. Both patients underwent deceased liver transplantation 15 and 29 months after the initial COVID-19 diagnosis. One patient had good recovery and good liver function two years after LT and the other died in the fourth month after LT of disseminated infection and diffuse bleeding.