Coronavirus (COVID-19) Information for Liver Transplant Patients

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

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 at an increased risk for COVID-19 illness.

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.

What should we do to limit risk of infection?

• COVID-19 vaccination is recommended for all eligible patients. Patients who are immunosuppressed due to medications for solid organ transplant are recommended to receive the two dose regimen of mRNA COVID-19 vaccines offered by Moderna or Pfizer, and one to two booster doses, depending on age. The schedule for COVID-19 vaccination by age group for immunocompromised patients can be found here. If your child has had recent rejection and is on steroid therapy, please discuss vaccination with your child’s liver doctor.
• It is important that the family and regular close contacts of children with a liver transplant be vaccinated as well. Vaccinating the people around a vulnerable person is called cocooning and is a valuable and effective tool to protect your family.
• Stay informed about the rate of infections in your community. During times of increased rates of infection, you may choose to limit trips outside of the home except for groceries, prescriptions, medical appointments, and your routine lab testing. Check with your pharmacy for home delivery options and 90-day supplies (90-day prescriptions will require an updated prescription from your liver doctor).
• Continue wearing a mask in indoor environments outside of your home and in any situation where social distancing is hard to maintain. For children too young to mask, we recommend you use the stroller bubbles provided by Cincinnati Children’s.
• 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.
• It is fine to walk outside, maintaining social distance of 6 feet from others outside your home. Please avoid playgrounds or other crowded areas.
• Cincinnati Children’s will provide a surgical-style face mask for every visitor, patient, family member and employee to wear while on campus facilities.

Are there any current changes to routine testing, clinic visits and procedures?

• No. Routine labs, clinics, and any procedures deemed necessary by your liver doctor should proceed as usual. If you or your child have recently been diagnosed with or have symptoms of COVID-19, please call your Transplant Coordinator at 513-636-4955 prior to your appointment.

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?

What are other resources for liver transplant patients?

• The American Society of Transplantation has helpful resources for the transplant community
• The CDC provides resources on COVID-19 levels by community to help you stay informed
• Guidance for Parents of Immunocompromised Patients