Datasheet1_Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey.pdf

BackgroundDespite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers.MethodsA digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers.ResultsOut of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (−3.1, p = 0.002).ConclusionCOVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population.</p

Datasheet2_Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey.pdf

BackgroundDespite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers.MethodsA digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers.ResultsOut of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (−3.1, p = 0.002).ConclusionCOVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population.</p

Datasheet3_Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey.docx

BackgroundDespite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers.MethodsA digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers.ResultsOut of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (−3.1, p = 0.002).ConclusionCOVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population.</p

Drug classes used as comedication when beginning DAA therapy, by severity of liver disease, among HCV-infected patients.

<p>Drug classes used as comedication when beginning DAA therapy, by severity of liver disease, among HCV-infected patients.</p

Number of co-medications used and percentage of patients, by DAA regimen, among HCV-infected patients.

<p>(A) Patients with mild liver disease. (B) Patients with moderate-to severe-liver disease. SOF/RBV: sofosbuvir plus ribavirin, SOF/SIM: sofosbuvir plus simeprevir, SOF/DCV: sofosbuvir plus daclatasvir, SOF/LDV: sofosbuvir plus ledipasvir, 3D: paritaprevir/ritonavir, ombitasvir, dasabuvir. The percentage of patients who took one drug (in blu), two drugs (in red), three drugs (in green) and more than 3 drugs (in violet) are reported considering the total number of patients reported for each regimen in both Fig 1A and Fig 1B at the same manner.</p

Category of potential DDIs, by DAA regimen and severity of liver disease, among HCV-infected patients.

<p>Comedication used in patients with mild liver disease (A) or in (B) patients with moderate-to severe-liver disease (B). DAA regiments and number of comedications used are shown. SOF/RBV: sofosbuvir plus ribavirin, SOF/SIM: sofosbuvir plus simeprevir, SOF/DCV: sofosbuvir plus daclatasvir, SOF/LDV: sofosbuvir plus ledipasvir, 3D: paritaprevir/ritonavir, ombitasvir, dasabuvir. Category 0: Classification not possible due to lack of information; Category 1: No clinical interaction possible; Category 2: May require dose adjustment/closer monitoring.</p

Sociodemographic and virological characteristics and comedications used, by severity of liver disease, among HCV-infected patients undergoing DAA therapy.

<p>Sociodemographic and virological characteristics and comedications used, by severity of liver disease, among HCV-infected patients undergoing DAA therapy.</p

The most common drugs with a potential DDI among HCV-infected patients with moderate-to-severe liver disease.

<p>The most common drugs with a potential DDI among HCV-infected patients with moderate-to-severe liver disease.</p

Failure rates following the first DAA regimen, by HCV genotype and treatment regimen in patients who completed the 12 weeks post treatment evaluation (n = 3,830 patients).

<p>Failure rates following the first DAA regimen, by HCV genotype and treatment regimen in patients who completed the 12 weeks post treatment evaluation (n = 3,830 patients).</p

Univariate and logistic regression analysis linking failure with independent variables.

<p>Univariate and logistic regression analysis linking failure with independent variables.</p