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World J Transplant . Success of intravenous immunoglobulin and steroids in managing severe COVID-19 following lung transplantation: A case report

tetano

Editor, Senior Moderator
World J Transplant


. 2025 Mar 18;15(1):96696.
doi: 10.5500/wjt.v15.i1.96696. Success of intravenous immunoglobulin and steroids in managing severe COVID-19 following lung transplantation: A case report

Yen-Shou Kuo[SUP] 1 [/SUP], Kuan-Hsun Lin[SUP] 1 [/SUP], Ying-Yi Chen[SUP] 1 [/SUP], Yuan-Ming Tsai[SUP] 1 [/SUP], Ti-Hui Wu[SUP] 1 [/SUP], Hsu-Kai Huang[SUP] 1 [/SUP], Tsai-Wang Huang[SUP] 2 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease 2019 (COVID-19) pneumonia with severe septic shock and acute respiratory distress syndrome (ARDS) are critical illnesses for patients following transplant. Intravenous immunoglobulin (IVIG) plays a role in both immune support and inflammation control, especially in immunocompromised patients. This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.
Case summary: A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations. Postoperatively, he developed COVID-19 pneumonia, severe septic shock, and ARDS. He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation, in addition to IVIG and pulse steroids.
Conclusion: IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection. We aim, for the first time, to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting. With further investigations, this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.

Keywords: COVID-19; Case report; Intravenous immunoglobulin; Lung transplantation; Post-transplant complications; Septic shock.

 
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