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Lung Transplantation for COVID-19 Pulmonary Sequelae.
Kehara, Hiromu; Mangukia, Chirantan; Sunagawa, Gengo; Iturra, Sebastian A; Yanagida, Roh; Kashem, Mohammed; Persidsky, Yuri; Shenoy, Kartik; Mamary, Albert J; Marchetti, Nathaniel; Cordova, Francis; Criner, Gerard J; Toyoda, Yoshiya; Shigemura, Norihisa.
  • Kehara H; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Mangukia C; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Sunagawa G; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Iturra SA; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Yanagida R; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Kashem M; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Persidsky Y; Department of Pathology and Laboratory Medicine, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Shenoy K; Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA.
  • Mamary AJ; Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA.
  • Marchetti N; Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA.
  • Cordova F; Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA.
  • Criner GJ; Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, PA.
  • Toyoda Y; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
  • Shigemura N; Division of Cardiovascular Surgery, Temple University and Lewis Katz School of Medicine, Philadelphia, PA.
Transplantation ; 107(2): 449-456, 2023 02 01.
Article in English | MEDLINE | ID: covidwho-2231748
ABSTRACT

BACKGROUND:

The role of lung transplantation for coronavirus disease 2019 (COVID-19)-related lung failure is evolving as the pandemic persists.

METHODS:

From January 2021 to April 2022, 20 patients (median age 62 y; range 31-77) underwent lung transplantation for COVID-related lung failure at our institution. We reviewed their clinical and intraoperative characteristics and early outcomes including postoperative complications.

RESULTS:

Eleven patients (55%) had chronic lung disease when they contracted COVID-19. All 20 patients required hospitalization for antivirus treatment. Median lung allocation score was 74.7 (33.1-94.0). Thirteen patients (65%) underwent single-lung transplants, and 7 patients (35%) underwent double-lung transplants. Concomitant coronary artery bypass graft surgery was performed in 2 (10%) patients because of severe coronary artery disease. Postoperatively, venovenous extracorporeal membrane oxygenation was needed in 3 patients (15%) because of severe primary graft dysfunction; all were eventually weaned. Ten patients (50%) experienced deep venous thrombosis, and 1 eventually developed a major pulmonary embolus. The median intensive care unit stay and hospital stays were 6.5 d (3-44) and 18 d (7-77), respectively. During a median follow-up of 201 d (47-418), we experienced 1 late mortality due to COVID-19-related myocarditis. Among the 13 patients with single-lung transplant, 5 demonstrated improvement in their native lungs.

CONCLUSIONS:

Lung transplantation yielded favorable early outcomes in a heterogeneous patient cohort that included older patients, obese patients, and patients with coronary artery disease or preexisting chronic lung disease. Our data also shed light on the transforming role of lung transplantation for the pulmonary sequelae of a complex multisystem COVID-19 disorder.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronary Artery Disease / Lung Transplantation / COVID-19 / Lung Diseases Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: Transplantation Year: 2023 Document Type: Article Affiliation country: TP.0000000000004428

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronary Artery Disease / Lung Transplantation / COVID-19 / Lung Diseases Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: Transplantation Year: 2023 Document Type: Article Affiliation country: TP.0000000000004428