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  1. Article: Transplant of SARS-CoV-2-infected Living Donor Liver: Case Report.

    Nguyen, Michelle C / Lee, Eliza J / Avery, Robin K / Dioverti-Prono, M Veronica / Shoham, Shmuel / Tobian, Aaron A R / Bloch, Evan M / Gurakar, Ahmet / Rizkalla, Nicole A / Cameron, Andrew M / King, Elizabeth A / Ottmann, Shane / Garonzik-Wang, Jacqueline M / Wesson, Russel N / Philosophe, Benjamin

    Transplantation direct

    2021  Volume 7, Issue 8, Page(s) e721

    Abstract: ... to inform the risk of transplant transmission of SARS-CoV-2. We report a case of a living donor ... transplant programs will encounter SARS-CoV-2 infections in living donors or recipients ... liver transplant recipient who received a right lobe graft from a living donor with symptomatic PCR-confirmed SARS ...

    Abstract Given the high community prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transplant programs will encounter SARS-CoV-2 infections in living donors or recipients in the perioperative period. There is limited data on SARS-CoV-2 viremia and organotropism beyond the respiratory tract to inform the risk of transplant transmission of SARS-CoV-2. We report a case of a living donor liver transplant recipient who received a right lobe graft from a living donor with symptomatic PCR-confirmed SARS-CoV-2 infection 3 d following donation. The donor was successfully treated with remdesivir, dexamethasone, and coronavirus disease 2019 (COVID-19) convalescent plasma. No viral transmission was identified, and both donor and recipient had excellent postoperative outcomes.
    Language English
    Publishing date 2021-07-08
    Publishing country United States
    Document type Journal Article
    ISSN 2373-8731
    ISSN 2373-8731
    DOI 10.1097/TXD.0000000000001178
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Recurrent Hepatic Artery Thrombosis Following Living Donor Liver Transplant as Sequelae of SARS-CoV-2 Infection-a Case Report.

    Raj, Anupam / Shankar, Vijay / Singhal, Saurabh / Goyal, Neerav / Arunkumar, Venuthurimilli / Garg, Hitendra Kumar / Pal, Atish

    SN comprehensive clinical medicine

    2021  Volume 3, Issue 12, Page(s) 2629–2634

    Abstract: ... increasingly receiving patients recovered from SARS-CoV-2 infection in recent few weeks. Unexpected ... There is a lot of evidence suggesting that patients with SARS-CoV-2 infection tend to be hypercoagulable ... year-old gentleman with decompensated liver disease 23 days after recovering from a mild SARS-CoV-2 ...

    Abstract As the second wave of COVID-19 disease is gripping the globe, liver transplant centers are increasingly receiving patients recovered from SARS-CoV-2 infection in recent few weeks. Unexpected complications in these patients are increasingly being recognized. We performed liver transplantation on a 51-year-old gentleman with decompensated liver disease 23 days after recovering from a mild SARS-CoV-2 infection. Surprisingly, despite massive blood loss and a prolonged anhepatic phase, his thromboelastographic (TEG) parameters persistently revealed hypercoagulability. After a brief uneventful early post-operative period, he developed hepatic arterial thrombosis on the 14th post-operative day, and again after 4 days, both of which required surgical intervention. Following discharge, the artery was thrombosed again which was only picked up when he developed a cholangiolar abscess, leading to graft loss necessitating re-transplantation. There is a lot of evidence suggesting that patients with SARS-CoV-2 infection tend to be hypercoagulable. We believe that this hypercoagulability might have played a significant role in the development of hepatic arterial thrombosis and eventual graft loss in this patient. This highlights the importance of revisiting anticoagulation protocols in liver transplant recipients recovered from COVID-19 and base them on TEG rather than routine parameters such as INR and APTT, which are routinely deranged in such patients.
    Language English
    Publishing date 2021-10-08
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2947211-8
    ISSN 2523-8973 ; 2523-8973
    ISSN (online) 2523-8973
    ISSN 2523-8973
    DOI 10.1007/s42399-021-01076-y
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  3. Article ; Online: Liver transplant after SARS-CoV-2 infection: A systematic review.

    Nacif, Lucas S / Fernandes, Michel Ribeiro / Waisberg, Daniel R / Pinheiro, Rafael S / Rocha-Santos, Vinicius / Galvão, Flávio / Andraus, Wellington / Carneiro-D'Albuquerque, Luiz

    Clinics (Sao Paulo, Brazil)

    2022  Volume 77, Page(s) 100042

    Abstract: ... for surgery after SARS-CoV-2 infection remains undetermined. This study aims to expand the current knowledge ... COVID-19 to LT was 19 days (13.5‒44.5). Deceased donor liver transplantation accounted for 61% of cases ... while living donor transplantation was 39%.: Conclusion: Despite the concerns regarding the postoperative ...

    Abstract Background: The Coronavirus 19 (COVID-19) pandemic has dramatically impacted liver organ transplantation. The American Society of Transplantation recommends a minimum of 28 days after symptom resolution for organ donation. However, the exact time for transplantation for recipients is unknown. Considering that mortality on the waiting list for patients with MELD >25 or fulminant hepatitis is higher than that of COVID-19, the best time for surgery after SARS-CoV-2 infection remains undetermined. This study aims to expand the current knowledge regarding the Liver Transplantation (LT) time for patients after COVID-19 and to provide transplant physicians with essential decision-making tools to manage these critically ill patients during the pandemic.
    Methods: Systematic review of patients who underwent liver transplantation after diagnosis of COVID-19. The MEDLINE, PubMed, Cochrane, Lilacs, Embase, and Scielo databases were searched until June 20, 2021. The MESH terms used were "COVID-19" and "Liver transplantation".
    Results: 558 articles were found; of these 13 articles and a total of 18 cases of COVID-19 prior to liver transplantation were reported. The mean age was 38.7±14.6, with male prevalence. Most had mild symptoms of COVID. Five patients have specific treatment for COVID-19 with convalescent plasm or remdesivir/oseltamivir, just one patient received hydroxychloroquine, and 12 patients received only symptomatic treatment. The median time between COVID-19 to LT was 19 days (13.5‒44.5). Deceased donor liver transplantation accounted for 61% of cases, while living donor transplantation was 39%.
    Conclusion: Despite the concerns regarding the postoperative evolution, the mortality of patients with high MELD or fulminant hepatitis transplanted shortly after COVID-19 diagnosis does not seem to be higher. (PROSPERO, registration number = CRD42021261790).
    Language English
    Publishing date 2022-04-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.1016/j.clinsp.2022.100042
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  4. Article: Solid Organ Transplantation in SARS-CoV-2 Recovered Transplant Candidates: a Comprehensive Review of Recent Literature.

    Kute, Vivek / Meshram, Hari Shankar / Fleetwood, Vidya A / Chauhan, Sanshriti / Lentine, Krista L

    Current transplantation reports

    2022  Volume 9, Issue 2, Page(s) 95–107

    Abstract: ... patients. The majority of these were living donor transplants. A positive SARS-CoV-2 antibody test ... of inadvertent transplantation with active SARS-CoV-2. Available reports are predominantly in kidney transplant ... candidates who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and ...

    Abstract Purpose of review: As the coronavirus disease 2019 (COVID-19) pandemic continues to surge, determining the safety and timing of proceeding with solid organ transplantation (SOT) in transplant candidates who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and who are otherwise transplant eligible is an important concern. We reviewed the current status of protocols and the outcomes of SOT in SARS-CoV-2 recovered patients.
    Recent findings: We identified 44 published reports up through 7 September 2021, comprising 183 SOT [kidney = 115; lung = 27; liver = 36; heart = 3; simultaneous pancreas-kidney (SPK) = 1, small bowel = 1] transplants in SARS-CoV-2 recovered patients. The majority of these were living donor transplants. A positive SARS-CoV-2 antibody test, although not obligatory in most reports, was a useful tool to strengthen the decision to proceed with transplant. Two consecutive real-time polymerase chain test (RT-PCR) negative tests was one of the main prerequisites for transplant in many reports. However, some reports suggest that life-saving transplantation can proceed in select circumstances without waiting for a negative RT-PCR. In general, the standard immunosuppression regimen was not changed.
    Summary: In select cases, SOT in COVID-19 recovered patients appears successful in short-term follow-up. Emergency SOT can be performed with active SARS-CoV-2 infection in some cases. In general, continuing standard immunosuppression regimen may be reasonable, except in cases of inadvertent transplantation with active SARS-CoV-2. Available reports are predominantly in kidney transplant recipients, and more data for other organ transplants are needed.
    Language English
    Publishing date 2022-03-09
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 2196-3029
    ISSN 2196-3029
    DOI 10.1007/s40472-022-00362-5
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  5. Article ; Online: A Recipient and Donor Both Have COVID-19 Disease. Should We Perform a Liver Transplant?

    Tuncer, Adem / Akbulut, Sami / Baskiran, Adil / Karakas, Ezgi Erdal / Baskiran, Deniz Yavuz / Carr, Brian / Yilmaz, Sezai

    Journal of gastrointestinal cancer

    2021  Volume 52, Issue 3, Page(s) 1143–1147

    Abstract: ... growing concern about donor-induced transmission of Coronavirus 2 (SARS -CoV-2). For liver transplantation ... received a living donor liver transplant. We present a case of donor and recipient who initially ... radiological examination 24-48 h before surgery. One of the liver transplant candidates was found to be infected with COVID ...

    Abstract Coronavirus 2019 (COVID-19) is a new infectious disease that continues to spread globally. There is growing concern about donor-induced transmission of Coronavirus 2 (SARS -CoV-2). For liver transplantation, the COVID-19 PCR test is routine, in addition to epidemiological history and clinical and radiological examination 24-48 h before surgery. One of the liver transplant candidates was found to be infected with COVID-19, as well as the planned donor candidate. Since COVID-19 will be a high-risk operation for both the recipient and the donor, the operation was postponed by giving medical treatment. After the treatment and quarantine process was over, the patient and the donor then had a negative COVID-19 PCR test and the patient received a living donor liver transplant. We present a case of donor and recipient who initially both tested positive for COVID-19. This liver transplantation scenario has not previously been reported in the literature.
    MeSH term(s) Adult ; COVID-19/diagnosis ; COVID-19/drug therapy ; COVID-19/prevention & control ; COVID-19/transmission ; Donor Selection/standards ; End Stage Liver Disease/surgery ; Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/standards ; Living Donors ; Male ; Middle Aged ; Postoperative Complications/prevention & control ; Postoperative Complications/virology ; Postoperative Period ; Preoperative Period ; SARS-CoV-2/isolation & purification ; Treatment Outcome
    Language English
    Publishing date 2021-02-18
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2452514-5
    ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
    ISSN (online) 1941-6636 ; 1559-0739
    ISSN 1941-6628 ; 1537-3649
    DOI 10.1007/s12029-021-00590-5
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    Zs.A 2184: Show issues Location:
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  6. Article ; Online: Incidence of Coronavirus Infection in Patients Undergoing Kidney Transplant During the Pandemic Period in Uzbekistan.

    Bakhritdinov, Fazlitdin Sh / Ibadov, Ravshan A / Azimova, Marguba T / Matkarimov, Zokhidjon T / Komilova, Dildora N / Elmurodova, Nigina B

    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

    2022  Volume 20, Issue Suppl 4, Page(s) 74–79

    Abstract: ... who underwent kidney transplant living related donors during the global pandemic in Uzbekistan.: Materials and ... kidney transplant recipients of living related donors had fewer complications of the disease than expected. ... kidney transplants from living related donors between 2017 and 2022, with 320 procedures during the pandemic. There ...

    Abstract Objectives: The COVID-19 pandemic has hit the world in an almost unprecedented way. Patients with endstage chronic renal failure, who are on hemodialysis, with glomerulonephritis and complicated pyelonephritis and other nephrological diseases, were under constant close supervision of specialists, despite the existing difficulties for face-to-face contact between the patient and the doctor at our hospital in Tashkent, Uzbekistan, where primary detection and treatment of these patients were also actively conducted. Here, we report the features of the course of treatment for COVID-19 infection in patients who underwent kidney transplant living related donors during the global pandemic in Uzbekistan.
    Materials and methods: After a decree from the Cabinet of Ministers of the Republic of Uzbekistan in October 2017 for approval and regulations for related kidney and (or) liver lobe procedures, our center performed 609 kidney transplants from living related donors between 2017 and 2022, with 320 procedures during the pandemic. There were 228 transplant recipients with COVID-19 infections and COVID-19-associated pneumonia.
    Results: Of total cases with COVID-19, 71% had moderate disease severity. Of patients who under went kidney transplant, 42% had pneumonia associated with COVID-19 infection. After lung damage was confirmed by multislice computed tomography of the lungs, patients were sent to the intensive care unit for appropriate treatment to ensure a quick recovery without possible complications to the graft.
    Conclusions: The Ministry of Health of the Republic of Uzbekistan indicated the possibility of treatment of patients with moderate and severe COVID-19 disease with monoclonal antibodies that block interleukin 6 receptors (tocilizumab and sarilumab). With timely detection of symptoms of COVID-19infection, treatment, and the use of prevention methods, kidney transplant recipients of living related donors had fewer complications of the disease than expected.
    MeSH term(s) COVID-19 ; Humans ; Incidence ; Kidney Transplantation ; Pandemics ; SARS-CoV-2 ; Transplant Recipients ; Treatment Outcome ; Uzbekistan
    Language English
    Publishing date 2022-08-26
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2396778-X
    ISSN 2146-8427 ; 1304-0855
    ISSN (online) 2146-8427
    ISSN 1304-0855
    DOI 10.6002/ect.DonorSymp.2022.O15
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    Zs.A 6632: Show issues Location:
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  7. Article ; Online: The case of a liver-transplant recipient with severe acute respiratory syndrome coronavirus 2 infection who had a favorable outcome.

    Hayashi, Kazuhiko / Ito, Yuki / Yamane, Ryosuke / Yoshizaki, Michiyo / Matsushita, Komei / Kajikawa, Go / Kozawa, Takashi / Mizutani, Taro / Shimizu, Yuko / Nagano, Kenichi / Tachi, Kosuke / Yoshioka, Kentaro / Goto, Hidemi

    Clinical journal of gastroenterology

    2021  Volume 14, Issue 3, Page(s) 842–845

    Abstract: ... with SARS-CoV-2. A 20-year-old man who had undergone living-donor liver transplantation from his father at 5 ... complications related to COVID-19. Here, we report the case of liver-transplant recipients who were infected ... years of age because of congenital biliary atresia was referred to our hospital for SARS-CoV-2 infection ...

    Abstract The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in 2019; thereafter, the COVID-19 outbreak became a health emergency of international concern. The impact of COVID-19 on liver-transplant recipients is unclear. Thus, it is currently unknown whether liver-transplant recipients are at a higher risk of developing complications related to COVID-19. Here, we report the case of liver-transplant recipients who were infected with SARS-CoV-2. A 20-year-old man who had undergone living-donor liver transplantation from his father at 5 years of age because of congenital biliary atresia was referred to our hospital for SARS-CoV-2 infection. Chest computed tomography did not show any abnormalities; however, laboratory results revealed liver dysfunction. He received tacrolimus as maintenance therapy that was continued at the same dose. He has not developed severe pulmonary disease and was discharged after 10 days of hospitalization. Limited data are available on post-transplant patients with COVID-19, and this case of a young patient without metabolic comorbidities did not show any association of severe COVID-19 under tacrolimus treatment. The progression of COVID-19 in liver-transplant recipients is complex, and COVID-19 risk should be evaluated in each patient until the establishment of optimal guidelines.
    MeSH term(s) Adult ; COVID-19/diagnosis ; COVID-19 Testing ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Liver Transplantation/adverse effects ; Living Donors ; Male ; Postoperative Complications/diagnosis ; Postoperative Complications/drug therapy ; Postoperative Complications/etiology ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification ; Tacrolimus/therapeutic use ; Transplant Recipients ; Treatment Outcome ; Young Adult
    Chemical Substances Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2021-03-06
    Publishing country Japan
    Document type Case Reports ; Journal Article
    ZDB-ID 2429411-1
    ISSN 1865-7265 ; 1865-7257
    ISSN (online) 1865-7265
    ISSN 1865-7257
    DOI 10.1007/s12328-021-01374-x
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  8. Article ; Online: Clinical characteristics and immunosuppressant management of coronavirus disease 2019 in solid organ transplant recipients.

    Zhong, Zibiao / Zhang, Qiuyan / Xia, Haoyang / Wang, Aiping / Liang, Wenjin / Zhou, Wei / Zhou, Lihua / Liu, Xiao / Rao, Lingzhang / Li, Zhifeng / Peng, Zhiyong / Mo, Pingzheng / Xiong, Yong / Ye, Shaojun / Wang, Yanfeng / Ye, Qifa

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2020  Volume 20, Issue 7, Page(s) 1916–1921

    Abstract: ... had undergone a renal transplant from a living-related donor 17 years ago, and was admitted ... outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available ... especially data about the management of immunosuppressants. We report two cases of COVID-19 in two ...

    Abstract Over 1 000 000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 9 days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living-related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.
    MeSH term(s) Adult ; Betacoronavirus ; COVID-19 ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/surgery ; Coronavirus Infections/complications ; Coronavirus Infections/therapy ; Hepatitis B/complications ; Hepatitis B/surgery ; Hepatitis B virus ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Liver Neoplasms/complications ; Liver Neoplasms/surgery ; Liver Transplantation ; Male ; Methylprednisolone/administration & dosage ; Middle Aged ; Organ Transplantation ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/therapy ; Prognosis ; SARS-CoV-2 ; Transplant Recipients ; Treatment Outcome
    Chemical Substances Immunosuppressive Agents ; Methylprednisolone (X4W7ZR7023)
    Keywords covid19
    Language English
    Publishing date 2020-05-04
    Publishing country United States
    Document type Case Reports ; Research Support, Non-U.S. Gov't
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15928
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    Zs.A 5542: Show issues Location:
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  9. Article ; Online: Successful liver transplantation from deceased donors with active COVID-19 infections with undetectable SARS-CoV-2 in donor liver and aorta.

    Weeks, Sharon R / Federova, Ekateria / Lee, Kyungho / Nyberg, Lyle / Mulka, Kathleen / Rabb, Hamid / Pekosz, Andrew / Philosophe, Benjamin / Mankowski, Joseph

    Clinical transplantation

    2023  Volume 37, Issue 9, Page(s) e15081

    Abstract: ... Several successful case reports describing incidental transplant of organs from donors with COVID-19 infections or ... or molecular evidence of SARS-CoV-2 transmission in donor tissues.: Conclusion: This evidence ... from deceased donors with active COVID-19 infections. Donor liver and aortic tissues were evaluated by sensitive ...

    Abstract Background: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had unprecedented effects on society and modern healthcare. In liver transplantation, uncertainty regarding the safety of performing transplants during the early stage of the pandemic resulted in increased waitlist mortality. Additionally, concerns about disease transmission led to avoidance of deceased donors with COVID-19 infections. Several successful case reports describing incidental transplant of organs from donors with COVID-19 infections or intentional transplant of such donors into recipients with current or prior COVID-19 infections prompted the transplant community to re-evaluate that position. While excellent short-term results have been published, little is known about use of donors with active infections and the extent of COVID-19 organ involvement, which may affect long term outcomes.
    Methods: We report the successful transplantation of three livers from deceased donors with active COVID-19 infections. Donor liver and aortic tissues were evaluated by sensitive molecular testing for SARS-CoV-2 RNA via in situ hybridization and real-time quantitative reverse transcription PCR.
    Results: Postoperatively, all patients had excellent allograft function, without clinical or molecular evidence of SARS-CoV-2 transmission in donor tissues.
    Conclusion: This evidence supports the use of liver donors with active COVID-19 infections.
    MeSH term(s) Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Liver Transplantation/methods ; Pandemics ; RNA, Viral/genetics ; Tissue and Organ Procurement ; Living Donors ; Tissue Donors ; Liver ; Aorta
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2023-07-27
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.15081
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  10. Article ; Online: COVID-19 infection in a child following liver transplantation.

    Sindwani, G / Abhinaya, S V / Arora, M K / Pamecha, V / Lal, B B

    Anaesthesia reports

    2021  Volume 9, Issue 2, Page(s) e12139

    Abstract: ... situation. In this report, we present the case of an 11-year-old girl who underwent emergency living donor ... A polymerase chain reaction test was positive for SARS-CoV-2 virus and a hypercoagulable state was indicated by laboratory ... COVID-19 infection immediately after liver transplantation presents a unique and challenging ...

    Abstract COVID-19 infection immediately after liver transplantation presents a unique and challenging situation. In this report, we present the case of an 11-year-old girl who underwent emergency living donor liver transplantation for acute liver failure. After an uneventful intra-operative course, the patient was transferred to the intensive care unit. On the second postoperative day, the patient developed unexplained severe hypoxia. A polymerase chain reaction test was positive for SARS-CoV-2 virus and a hypercoagulable state was indicated by laboratory investigations. Despite therapies such as mechanical ventilation and therapeutic anticoagulation, further clinical deterioration occurred. On the seventh postoperative day, the patient's pupils were fully dilated bilaterally and unreactive to light, and brain death was later confirmed. This report highlights unique challenges pertaining to oxygenation, coagulation and immunosuppression after liver transplantation in a child with COVID-19. Hypoxia of unknown origin in the postoperative period should prompt consideration of COVID-19 as a possible cause.
    Language English
    Publishing date 2021-12-03
    Publishing country England
    Document type Case Reports
    ISSN 2637-3726
    ISSN (online) 2637-3726
    DOI 10.1002/anr3.12139
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