tetano
Editor, Senior Moderator
Eur Respir J
. 2022 Mar 17;2102404.
doi: 10.1183/13993003.02404-2021. Online ahead of print.
Clinical relevance of lung transplantation for COVID-19 ARDS: a nationwide study
Christian Lang[SUP] 1 [/SUP], Valentin Ritschl[SUP] 2 3 [/SUP], Florian Augustin[SUP] 4 [/SUP], Gyoergy Lang[SUP] 1 [/SUP], Bernhard Moser[SUP] 1 [/SUP], Shahrokh Taghavi[SUP] 1 [/SUP], Gabriella Murakoezy[SUP] 1 [/SUP], Christopher Lambers[SUP] 5 [/SUP], Holger Flick[SUP] 6 [/SUP], Markus Koestenberger[SUP] 7 [/SUP], Roxane Brooks[SUP] 8 [/SUP], Tina Muhr[SUP] 9 [/SUP], Johann Knotzer[SUP] 10 [/SUP], Daniel Mydza[SUP] 11 [/SUP], Marc Kaufmann[SUP] 12 [/SUP], Thomas Staudinger[SUP] 13 [/SUP], Christian Zauner[SUP] 14 [/SUP], Claus Krenn[SUP] 15 [/SUP], Eva Schaden[SUP] 15 16 [/SUP], Andreas Bacher[SUP] 17 [/SUP], Bernhard Rössler[SUP] 18 [/SUP], Peter Faybik[SUP] 19 [/SUP], Edda Tschernko[SUP] 20 [/SUP], Maria Anwar[SUP] 20 [/SUP], Klaus Markstaller[SUP] 21 [/SUP], Daniel Höfer[SUP] 22 [/SUP], Tanja Stamm[SUP] 2 3 [/SUP], Peter Jaksch[SUP] 1 [/SUP], Konrad Hoetzenecker[SUP] 23 [/SUP]
Affiliations
Abstract
Background: Although the number of lung transplantations (LTx) performed worldwide for COVID-19 induced acute respiratory distress syndrome (ARDS) is still low, there is general agreement that this treatment can save a subgroup of most severly ill patients with irreversible lung damage. However, the true proportion of patients eligible for LTx, the overall outcome and the impact of LTx to the pandemic are unknown.
Methods: A retrospective analysis was performed using a nationwide registry of hospitalised patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-Cov-2) infection admitted between January 1, 2020 and May 30, 2021 in Austria. Patients referred to one of the two Austrian LTx centers were analyzed and grouped into patients accepted and rejected for LTx. Detailed outcome analysis was performed for all patients who received a LTx for post-COVID-19 ARDS and compared to patients who underwent LTx for other indications.
Results: Between January 1, 2020 and May 30, 2021, 39.485 patients were hospitalised for COVID-19 in Austria. 2323 required mechanical ventilation, 183 received extra-corporeal membrane oxygenation (ECMO) support. 106 patients with severe COVID-19 ARDS were referred for LTx. Of these, 19 (18%) underwent LTx. 30-day mortality after LTx was 0% for COVID-19 ARDS transplant recipients. With a median follow-up of 134 (47-450) days, 14/19 patients are alive.
Conclusions: Early referral of ECMO patients to a LTx center is pivotal in order to select patients eligible for LTx. Transplantation offers excellent midterm outcomes and should be incorporated in the treatment algorithm of post-COVID-19 ARDS.
. 2022 Mar 17;2102404.
doi: 10.1183/13993003.02404-2021. Online ahead of print.
Clinical relevance of lung transplantation for COVID-19 ARDS: a nationwide study
Christian Lang[SUP] 1 [/SUP], Valentin Ritschl[SUP] 2 3 [/SUP], Florian Augustin[SUP] 4 [/SUP], Gyoergy Lang[SUP] 1 [/SUP], Bernhard Moser[SUP] 1 [/SUP], Shahrokh Taghavi[SUP] 1 [/SUP], Gabriella Murakoezy[SUP] 1 [/SUP], Christopher Lambers[SUP] 5 [/SUP], Holger Flick[SUP] 6 [/SUP], Markus Koestenberger[SUP] 7 [/SUP], Roxane Brooks[SUP] 8 [/SUP], Tina Muhr[SUP] 9 [/SUP], Johann Knotzer[SUP] 10 [/SUP], Daniel Mydza[SUP] 11 [/SUP], Marc Kaufmann[SUP] 12 [/SUP], Thomas Staudinger[SUP] 13 [/SUP], Christian Zauner[SUP] 14 [/SUP], Claus Krenn[SUP] 15 [/SUP], Eva Schaden[SUP] 15 16 [/SUP], Andreas Bacher[SUP] 17 [/SUP], Bernhard Rössler[SUP] 18 [/SUP], Peter Faybik[SUP] 19 [/SUP], Edda Tschernko[SUP] 20 [/SUP], Maria Anwar[SUP] 20 [/SUP], Klaus Markstaller[SUP] 21 [/SUP], Daniel Höfer[SUP] 22 [/SUP], Tanja Stamm[SUP] 2 3 [/SUP], Peter Jaksch[SUP] 1 [/SUP], Konrad Hoetzenecker[SUP] 23 [/SUP]
Affiliations
- PMID: 35301249
- DOI: 10.1183/13993003.02404-2021
Abstract
Background: Although the number of lung transplantations (LTx) performed worldwide for COVID-19 induced acute respiratory distress syndrome (ARDS) is still low, there is general agreement that this treatment can save a subgroup of most severly ill patients with irreversible lung damage. However, the true proportion of patients eligible for LTx, the overall outcome and the impact of LTx to the pandemic are unknown.
Methods: A retrospective analysis was performed using a nationwide registry of hospitalised patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-Cov-2) infection admitted between January 1, 2020 and May 30, 2021 in Austria. Patients referred to one of the two Austrian LTx centers were analyzed and grouped into patients accepted and rejected for LTx. Detailed outcome analysis was performed for all patients who received a LTx for post-COVID-19 ARDS and compared to patients who underwent LTx for other indications.
Results: Between January 1, 2020 and May 30, 2021, 39.485 patients were hospitalised for COVID-19 in Austria. 2323 required mechanical ventilation, 183 received extra-corporeal membrane oxygenation (ECMO) support. 106 patients with severe COVID-19 ARDS were referred for LTx. Of these, 19 (18%) underwent LTx. 30-day mortality after LTx was 0% for COVID-19 ARDS transplant recipients. With a median follow-up of 134 (47-450) days, 14/19 patients are alive.
Conclusions: Early referral of ECMO patients to a LTx center is pivotal in order to select patients eligible for LTx. Transplantation offers excellent midterm outcomes and should be incorporated in the treatment algorithm of post-COVID-19 ARDS.