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Lung transplantation has been advanced for nearly half a century around the globe, and it has been developed rapidly for over 20 years in China. The field of lung transplantation in China has been gradually integrated into the international community. The outbreak of novel coronavirus pneumonia (COVID-19) in 2020 brought big challenges, as well as diverted the worldwide attention to the development of lung transplantation in China, accelerating international communication and cooperation. With the steadily deepening of clinical and basic research on lung transplantation for severe cases of COVID-19, organ transplant physicians have deepened the understanding and thinking of the maintenance of donors, selection of elderly and pediatric candidates, and perioperative management of recipients, as the future perspective of lung transplantation in China. For interdisciplinary research related to lung transplantation, it is necessary to carry out multi-center clinical trials with qualified study design and constantly promote the theoretic and practical innovation.
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The outbreak of the novel coronavirus pneumonia (NCP), an acute infectious respiratory disease in Wuhan, China in December 2019, which was officially named COVID-19 by WHO, has caused enormous burden on society and health services. To ensure safe rehabilitation practice during the epidemic, the Chinese Association of Rehabilitation Medicine formed an expert group to develop a consensus statement for rehabilitation practice. The consensus statement provides guidance on: (1) safeguarding medical staff, patients, caregivers and visitors; and (2) timing and methods of effective rehabilitation interventions for treatment of COVID-19 patients. It also emphasizes that non-COVID-19 patients still require rehabilitation intervention during the epidemic outbreak, bearing in mind the safety of staff and patients and making adaptations according to the individual conditions and the patients′ actual environment. This expert consensus statement applies to departments of rehabilitation medicine and related disciplines in general hospitals as well as to specialized rehabilitation facilities, and it provides valuable reference for rehabilitation professionals working with infectious respiratory diseases in the future.
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Objective:To study the clinical medication regulation for the prevention and treatment of new coronavirus pneumonia with traditional Chinese medicine（TCM），especially prescriptions，on the basis of "treatment in accordance with seasonal conditions". Method:The guidelines and suggestions on novel coronavirus pneumonia formulated and published by national，provincial and municipal governments and experts before February 17，2020, were retrieved and summarized. Data was recorded in stages according to "prevention period，clinical observation period，pre-clinical period，middle clinical period，late clinical period and recovery period". The frequency analysis of TCM and its efficacy，prescription and proprietary Chinese medicine was carried out，and then the factor analysis and cluster analysis of TCM were carried out to obtain rational drug combinations. Result:Totally 172 suggestions on combined structure of drugs，50 suggestions on prescriptions and 31 suggestions on proprietary Chinese medicine were involved in the study，and provided by 24 official agencies and 24 medical experts， 147 kinds of herbs，44 prescriptions and 16 proprietary Chinese medicines were collected. No matter for the drug category or for the specific drug selection，the law of drug use in different stages was not the same. Huoxiang Zhengqi capsule，Shufeng Jiedu capsule，Lianhua Qingwen capsule and Jinhua Qinggan capsule can be used in the observation period. Xuanbai Chengqitang can be used in the middle of the disease. Angong Niuhuangwan，Suhexiangwan or Zixuedan, and Angong Niuhuangwan can be selected in the middle of the disease. And Qingfei Paidu decoction can be used in all stages of the disease. Conclusion:Doctors need to adjust their prescriptions along with the progress of the disease，because the law of medication in each stage of the new coronavirus pneumonia is different.
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Objective:To observe the therapeutic effect of Kesuting syrups and Keqing capsules, which have the function of promoting lung and resolving phlegm, on a mouse model combining disease and syndrome of human coronavirus pneumonia with cold-dampness pestilence attacking lung. Method:The therapeutic effects of Kesuting syrups (the doses of 22, 11 mL·kg-1) and Keqing capsules (the doses of 1.155, 0.577 5 g·kg-1) on this model were evaluated by the inflammatory changes of lung tissue, the expression of viral nucleic acid, the contents of inflammatory factors [interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α and interferon-γ (IFN-γ)], and the percentages of immune cells in peripheral blood (CD4+ T cells, CD8+ T cells and B cells). Result:Compared with the model group, high- and low-dose groups of Keqing capsules and Kesuting syrups could significantly reduce the inflammatory damage in the lung tissues of mice, Keqing capsules could significantly increase the percentages of CD4+ T cells, CD8+ T cells and B cells in peripheral blood, Keqing capsules and Kesuting syrups could reduce the expression levels of IL-6, IL-10, TNF-α and IFN-γ, inhibit the viral load in lung tissue, as well as improve the pathogenic manifestations of lung tissue. Conclusion:As the first-line drugs for novel coronavirus pneumonia, Keqing capsules and Kesuting syrups have significant therapeutic effect on the mouse model combining disease and syndrome of human coronavirus pneumonia with cold-dampness pestilence attacking lung, and the mechanism may be related to regulating immune function and reducing cytokine storm.
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This paper summarized the operation cooperation and management of the first case of bilateral lung transplantation assisted with double extracorporeal membrane oxygenation (ECMO) for the recipient with novel coronavirus pneumonia (COVID-19) in the world. The bilateral lung transplantation assisted by double ECMO had been accomplished successfully on a recipient with COVID-19, who was supported by ventilator and ECMO, with other organs function basically normal. The operation took 405 min and went smoothly. The cooperation and management guidelines of the operation room included the following: setting up of COVID-19 emergency operation group quickly; listing and preparing of the detailed operation supplies; transferring of the whole system of lung transplantation operating room in Wuxi People's Hospital to the Wuxi No.5 People's Hospital (isolation hospital); reconstruction of a negative pressure operating room for lung transplantation; formulating and strictly implementing the guidelines and management process for the operation of patient with COVID-19.
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Novel coronavirus pneumonia (COVID-19) is currently raging worldwide, and the prevention and control situation is very grim. Gratifying achievements of organ donation have been made in China since its implementation. Due to the characteristics of potential donors, such as complicated personnel structure, sudden onset and critical illness, it is necessary for multi-department to contact with the donors and their families during the work link of donor evaluation, family communication, donor transportation, organ function maintenance and organ procurement, which raises higher requirement for the screening and management of potential donors under COVID-19 epidemic. During the outbreak, Beijing Youan Hospital, Capital Medical University has completed 9 cases of organ donation, formulated the relevant screening process, established the prevention and control requirements, and gained certain experience and effects, which benefits the orderly and smooth development of organ donation under the COVID-19 epidemic.
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Objective To summarize the experience of organ donation after citizen' s death during the novel coronavirus pneumonia (COVID-19) epidemic. Methods Eleven cases of potential donors of organ donation after citizen' s death during the COVID-19 epidemic were retrospectively analyzed, and the workflow and key points of infectionprevention and control were summarized. Results Among 11 cases of potential donors, 6 cases failed to implement organ donation. Five donors who were successfully performed organ donation had no respiratory symptoms before the onset of encephalopathy. CT scan of the lungs upon the onset of encephalopathy showed that one case was diagnosed with aspiration pneumonia, and the remaining four cases obtained negative results. During hospitalization, all of the 5 donors showed fever symptom and repeated chest CT scan detected lung inflammation. Bronchoalveolar lavage fluid or blood samples tested for novel coronavirus nucleic acids were all negative. No confirmed or suspected cases appeared among all staff and recipients who were in close contact with organ donors. Conclusions Targeted formulation of the workflow and prevention and control measures, in combination with selection and implementation of infection risk classification can effectivelyreduce the risk of COVID-19 infection and carry out organ donation after citizen' s death in a safe and organized manner.
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In December 2019, a novel coronavirus pneumonia outbreak in Hubei Province spread rapidly to many provinces and cities. As organ transplantation is in the stage of high-quality development in China, how to carry out organ donation and transplantation in a scientific and orderly manner during the severe epidemic, summarize and analyze the clinical characteristics of COVID-19 on organ transplant recipients, and optimize the prevention, early diagnosis and treatment strategies of COVID-19 to ensure medical safety is essential to the development of organ transplantation and the treatment of the patients with end-stage organ failure as well as the overall situation of the prevention and control of COVID-19 epidemic. Thus, based on the instructions of the National Health Committee, the guidelines are issued by several experts organized by Branch of Organ Transplantation of Chinese Medical Association, providing help to the workers and managers of organ donation and transplantation in China. Approved by the Standing Committee of Branch of Organ Transplantation of Chinese Medical Association, the guidelines adopt the 'expert advice', 'prevention and control strategies' and 'guidance' published in China for reference, and will be revised upon changes of the further understanding of COVID-19 and epidemic control situation.
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In December 2019, a number of cases of pneumonia with unknown causes were successively reported in multiple hospitals in Wuhan City, Hubei Province, China. The pathogen is a novel coronavirus, which can lead to novel coronavirus pneumonia (COVID-19) and even threaten the patients' lives. In the following, the COVID-19 epidemic is spreading rapidly in many provinces and cities. It is particularly important to summarize and analyze the clinical characteristics of COVID-19 in solid organ transplantation (SOT) recipients and to optimize the prevention, early diagnosis and treatment strategies. Therefore, we organized Chinese experts in the field of organ transplantation to draft this article according to the characteristics of lung infection of SOT recipients and the characteristics of current COVID-19 by referring to relevant guidelines and specifications at home and abroad, aiming to provide reference for transplant physicians in China. This management strategy will be revised at any time with the deepening understanding of the COVID-19 infection.