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Comment
. 2021 Nov:80:100851.
doi: 10.1016/j.resmer.2021.100851. Epub 2021 Aug 8.

Lung transplantation for COVID-19-associated acute respiratory distress syndrome: The first French patient

M Glorion  1 , J De Wolf  2 , B Zuber  3 , F Cassiano  2 , S Preau  4 , A L Brun  5 , J Cohen  6 , G Tachon  3 , M Neuville  3 , O Brugière  7 , C Picard  7 , L Beaumont-Azuar  7 , J Fessler  8 , S Jacqmin  8 , C Pricopi  2 , A Chapelier  2 , E Cuquemelle  2 , F Parquin  2 , A Magnan  7 , A Roux  6 , M Le Guen  8 , E Sage  2 , C Cerf  8
Affiliations
Comment

Lung transplantation for COVID-19-associated acute respiratory distress syndrome: The first French patient

M Glorion et al. Respir Med Res. 2021 Nov.
No abstract available

Keywords: ARDS; COVID 19; Lung transplantation.

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Figures

Fig. 1
Fig. 1.
Chest CT scans, axial images with parenchymal window at day 17 (A), day 27 (B) and day 37 (C). (A) Bilateral, symmetrical pulmonary opacification with anteroposterior gradient, including dense consolidation in the dependant areas and ground glass opacities in the non-dependant lung consistent with early ARDS. (B) Worsening ground glass opacities associated with a few reticulations in the non-dependant regions. No evidence of underlying fixed fibrosis (normal appearance of the bronchial tree). (C) Partial resolution of the ground glass opacities. Coarse reticular pattern in the anterior, aerated lung with traction bronchiectasis suggesting underlying fibrosis. Multiple small and coalescent pulmonary cysts are probably related to prolonged ventilation.
Fig. 2
Fig. 2.
A: Chest x-rays the day of inscription on transplant waiting list (on day 43). B: Immediate Chest x-ray after lung transplantation. C: Discharge Chest x-ray POD 73 (on day 118).
Fig. 3
Fig. 3.
Clinical Time line (D: Day, MV: Mechanical Ventilation, ECMO: ExtraCorporeal Membrane Oxygenation, VV: Veno-Venous, RT-PCR: Sars cov 2 Real Time Polymerase Chain Reaction, POD: Post Operative Day, MRC: Medical Research Council sum neuromuscular score
Fig. 4
Fig. 4.
Microscopic images of haematoxylin and eosin staining of the explanted lungs. A: chronic scarring with architectural destruction in the form of a microcystic appearance (black arrows) of the pulmonary parenchyma due to dilated alveolar spaces. B: significant vascular changes with a significant amount of new vessel growth and fibrous and oedematous thickening of the media (black arrows) with very few thrombi. Interstitial fibrosis (red arrow). C: traction bronchiectasis (black arrow) with peribronchiolar metaplasia (red arrow) and vascular changes with fibrosis thickening of small vessel walls (blue arrow). D: interstitial fibrosis (red arrow) with mild to moderate interstitial inflammation composed of lymphocytes and plasma cells. Type II hyperplasia of the pneumocytes (black arrow).
See this image and copyright information in PMC

Comment on

  • When to consider lung transplantation for COVID-19.
    Cypel M, Keshavjee S. Cypel M, et al. Lancet Respir Med. 2020 Oct;8(10):944-946. doi: 10.1016/S2213-2600(20)30393-3. Epub 2020 Aug 25. Lancet Respir Med. 2020. PMID: 32857989 Free PMC article. No abstract available.

References

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