tetano
Editor, Senior Moderator
Ther Adv Respir Dis
. Jan-Dec 2022;16:17534666221081035.
doi: 10.1177/17534666221081035.
Lung transplantation for severe COVID-19-related ARDS
Ryoung-Eun Ko[SUP] 1 [/SUP], Dong Kyu Oh[SUP] 2 [/SUP], Sun Mi Choi[SUP] 3 [/SUP], Sunghoon Park[SUP] 4 [/SUP], Ji Eun Park[SUP] 5 [/SUP], Jin Gu Lee[SUP] 6 [/SUP], Young Tae Kim[SUP] 7 [/SUP], Kyeongman Jeon[SUP] 8 [/SUP]
Affiliations
Abstract
Background: Lung transplantation (LT) is the gold standard for various end-stage chronic lung diseases and could be a salvage therapeutic option in acute respiratory distress syndrome (ARDS). However, LT is uncertain in patients with coronavirus disease 2019 (COVID-19)-related ARDS who failed to recover despite optimal management including extracorporeal membrane oxygenation (ECMO). This study aims to describe the pooled experience of LT for patients with severe COVID-19-related ARDS in Korea.
Methods: A nationwide multicenter retrospective observational study was performed with consecutive LT for severe COVID-19-related ARDS in South Korea (June 2020-June 2021). Data were collected and compared with other LTs after bridging with ECMO from the Korean Organ Transplantation Registry.
Results: Eleven patients with COVID-19-related ARDS underwent LT. The median age was 60.0 years [interquartile range (IQR), 57.5-62.5; six males]. All patients were supported with venovenous ECMO at LT listing and received rehabilitation before LT. Patients were transplanted at a median of 49 (IQR, 32-66) days after ECMO cannulation. Primary graft dysfunction within 72 h of LT developed in two (18.2%). One patient expired 4 days after LT due to sepsis and one patient underwent retransplantation for graft failure. After a median follow-up of 322 (IQR, 299-397) days, 10 patients are alive and recovering well. Compared with other LTs after bridging with ECMO (n = 27), post-transplant outcomes were similar between the two groups.
Conclusions: LT in patients with unresolving COVID-19-related ARDS were effective with reasonable short-term outcome.
Keywords: COVID-19; extracorporeal membrane oxygenations; frailty; lung transplantation; treatment outcome.
. Jan-Dec 2022;16:17534666221081035.
doi: 10.1177/17534666221081035.
Lung transplantation for severe COVID-19-related ARDS
Ryoung-Eun Ko[SUP] 1 [/SUP], Dong Kyu Oh[SUP] 2 [/SUP], Sun Mi Choi[SUP] 3 [/SUP], Sunghoon Park[SUP] 4 [/SUP], Ji Eun Park[SUP] 5 [/SUP], Jin Gu Lee[SUP] 6 [/SUP], Young Tae Kim[SUP] 7 [/SUP], Kyeongman Jeon[SUP] 8 [/SUP]
Affiliations
- PMID: 35253546
- DOI: 10.1177/17534666221081035
Abstract
Background: Lung transplantation (LT) is the gold standard for various end-stage chronic lung diseases and could be a salvage therapeutic option in acute respiratory distress syndrome (ARDS). However, LT is uncertain in patients with coronavirus disease 2019 (COVID-19)-related ARDS who failed to recover despite optimal management including extracorporeal membrane oxygenation (ECMO). This study aims to describe the pooled experience of LT for patients with severe COVID-19-related ARDS in Korea.
Methods: A nationwide multicenter retrospective observational study was performed with consecutive LT for severe COVID-19-related ARDS in South Korea (June 2020-June 2021). Data were collected and compared with other LTs after bridging with ECMO from the Korean Organ Transplantation Registry.
Results: Eleven patients with COVID-19-related ARDS underwent LT. The median age was 60.0 years [interquartile range (IQR), 57.5-62.5; six males]. All patients were supported with venovenous ECMO at LT listing and received rehabilitation before LT. Patients were transplanted at a median of 49 (IQR, 32-66) days after ECMO cannulation. Primary graft dysfunction within 72 h of LT developed in two (18.2%). One patient expired 4 days after LT due to sepsis and one patient underwent retransplantation for graft failure. After a median follow-up of 322 (IQR, 299-397) days, 10 patients are alive and recovering well. Compared with other LTs after bridging with ECMO (n = 27), post-transplant outcomes were similar between the two groups.
Conclusions: LT in patients with unresolving COVID-19-related ARDS were effective with reasonable short-term outcome.
Keywords: COVID-19; extracorporeal membrane oxygenations; frailty; lung transplantation; treatment outcome.