Are kids who are awaiting or have received liver transplants at increased risk of developing COVID-19?

It is important to know that information about COVID-19 infection in kids with liver disease and liver transplant is very limited. It is thought that kids with cirrhosis, including those waiting for a liver transplant, may be more likely to contract COVID-19. Since kids with liver transplants are typically on medications that suppress the immune system, they are also probably more likely to contract COVID-19.

What should we do about getting routine testing?

If you are scheduled for routine bloodwork or other testing, please call the liver transplant office ahead of time. In many cases, if everything has been stable, we will try and delay routine bloodwork and other testing if possible. If things haven’t been stable, or there are concerns, we may not be able to change the timing of bloodwork or other testing.

What should we do about routine clinic visits?

We are working to reschedule routine clinic visits including annual transplant clinic visits. These could be in the form of in person visits or telehealth. If your liver team is actively managing medical issues while waiting for liver transplant or after liver transplant, you may still need to be seen in clinic. We are working hard to get as many clinic visits rescheduled as possible. While liver clinics are fully operational, given scheduling changes to maintain social distancing in the waiting room and in clinics, you may see a different liver doctor if your child needs an urgent visit.

What is the team doing about procedures?

In accordance with guidance from Ohio leaders and hospital guidelines, we are beginning to schedule elective procedures, including those that may have been postponed. Your liver team will give you information about when these will be scheduled. All patients undergoing procedures will get screened ahead of time for SARS-CoV-2. The medical team will give you more information on this when you are called with pre-operative instructions.

Should we make any changes to immunosuppressive medications with COVID-19 in the community?

No. Please do not make any adjustments to immunosuppressive medications because of the COVID-19 pandemic. This is thought to be risky, as it can prompt complications like rejection. Please continue to take medication as prescribed. Call your liver team if you have any questions.

How can we make sure we have enough medications and limit trips to the pharmacy?

  • You can call your pharmacy and/or your insurance provider and see if they will authorize 90-day supplies of prescriptions. If so, call the liver team for updated prescriptions.
  • Check with your pharmacy to see if they have a delivery option. Cincinnati Children’s main pharmacy will now be offering this service as well.
  • Call your liver team if you have any problems getting medications or supplies.

What should we do to limit risk of infection?

  • Wash hands thoroughly with soap and water for at least 20 seconds. Sing the ABCs to help you keep track. If that isn’t an option, use hand sanitizer. Make sure it contains at least 60% alcohol.
  • Try your best not to touch your eyes, nose, and mouth.
  • Avoid being near those who are sick.
  • Limit trips outside the home except for groceries, medical care, medicines.
  • It is fine to walk outside, maintaining social distance of 6 feet from others outside your home. Please avoid playgrounds or other crowded areas.
  • Recommendations on universal masking have been evolving. As of April 3rd, Cincinnati Children’s will provide a surgical-style face mask for every visitor, patient, family member, and employee to wear while on campus facilities. The CDC has recommended wearing cloth face masks in public settings wear other social distancing measures are difficult to maintain.

What should we do for ill symptoms?

  • Please call the liver team if children or teenagers experience ill symptoms while waiting for liver transplant or after receiving a liver transplant. Symptoms include fever over 100 degrees, cough, sore throat, changes in alertness, decreased urine or wet diapers, jaundice, or any other thing that might be concerning. The liver team will work with you to identify a plan of care.
  • Please call ahead before seeing the pediatrician or going to urgent care or the emergency room. The liver team can help coordinate care.

How can we support mental health during this time?

We recognize that the current COVID-19 pandemic can cause grief, anxiety, and fear. We are here to support you! Please reach out if you are having trouble. Also, our psychology team put together an excellent resource for those with chronic health conditions during this time.

What are other resources for liver transplant patients?