Lung transplantation after COVID-19-associated ARDS

The results of a first, international case series indicated that when lung transplantation is the only option for survival in patients with severe, unresolving, COVID-19-associated acute respiratory distress syndrome (ARDS), the procedure can be done successfully, with good early post-transplantation outcomes, in carefully selected patients.

Prof. G.R. Scott Budinger (Northwestern University, IL, USA) presented current data concerning COVID-19 patients at imminent risk of dying due to ARDS who had received lung transplantations [1–4]. He started by saying that “patients with COVID-19-associated ARDS who received lung transplants had similar outcomes compared with transplant patients without COVID-19, despite modestly increased early post-op complications.”

In the retrospective study, Prof. Budinger mostly focused on the case series including 102 patients who underwent a lung transplant at Northwestern Memorial Hospital between January 2020 and September 2021, including 30 patients who had COVID-19-associated ARDS [3]. While rates of transplant complications and length of stays in intensive care units were both higher in the group with COVID-19, patient survival in both groups was not significantly different. Overall, this data was very similar to that of the other studies [2,4].

Prof. Budinger pointed out that this finding is encouraging for the treatment of patients with COVID-19 who have no other options. Furthermore, the collective data can reassure the community that precious resources such as donor lungs will not necessarily have poorer outcomes in candidates with COVID-19.

1. Budinger GS, et al.Lung Transplantation for COVID-19-Associated ARDS. Session A2, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.
2. Bharat A, et al. Lancet Respir Med. 2021;9(5):487–497.
3. Kurihara C, et al. JAMA. 2022;327(7):652–661.
4. Roach A, et al. N Engl J Med 2022;386(12):1187–1188.

 

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Posted on 18 July 2022