Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Jan-Dec:16:17534666221081035.
doi: 10.1177/17534666221081035.

Lung transplantation for severe COVID-19-related ARDS

Ryoung-Eun Ko  1 , Dong Kyu Oh  2 , Sun Mi Choi  3 , Sunghoon Park  4 , Ji Eun Park  5 , Jin Gu Lee  6 , Young Tae Kim  7 , Kyeongman Jeon  8
Affiliations
Observational Study

Lung transplantation for severe COVID-19-related ARDS

Ryoung-Eun Ko et al. Ther Adv Respir Dis. 2022 Jan-Dec.

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study flow.
See this image and copyright information in PMC

References

    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020; 323: 2052–2059. - PMC - PubMed
    1. Buckner FS, McCulloch DJ, Atluri V, et al. Clinical features and outcomes of 105 hospitalized patients with COVID-19 in Seattle, Washington. Clin Infect Dis 2020; 71: 2167–2173. - PMC - PubMed
    1. Wunsch H. Mechanical ventilation in COVID-19: interpreting the current epidemiology. Am J Respir Crit Care Med 2020; 202: 1–4. - PMC - PubMed
    1. Lim ZJ, Subramaniam A, Ponnapa Reddy M, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation. A meta-analysis. Am J Respir Crit Care Med 2021; 203: 54–66. - PMC - PubMed
    1. Auld SC, Caridi-Scheible M, Blum JM, et al. ICU and ventilator mortality among critically ill adults with coronavirus disease 2019. Crit Care Med 2020; 48: e799–e804. - PMC - PubMed

Publication types