TY - JOUR
T1 - Post-Lung Transplantation Outcomes and Ex Vivo Histopathological Findings in Severe Post-COVID-19 Pulmonary Disease-A Single-Center Experience
AU - Javaid, Hana
AU - Nigo, Masayuki
AU - Zhao, Bihong
AU - Trujillo, Daniel Ocazionez
AU - Hasbun, Rodrigo
AU - Ostrosky-Zeichner, Luis
AU - Patel, Manish
AU - Jyothula, Soma
N1 - Funding Information:
Research grant and personal fees received from Biofire and personal fees received from Melinta Pharmaceuticals.
Publisher Copyright:
© The Author(s) 2022.
PY - 2022/9
Y1 - 2022/9
N2 - Background. A significant proportion of patients with severe and persistent coronavirus disease 2019 (COVID-19) require continuous ventilatory support and occasional extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). Lung transplantation is a treatment option for patients who develop severe ARDS. Methods. Our lung transplant database was retrospectively reviewed for patients who underwent lung transplantation for COVID-19 pulmonary disease at Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, from January 2020 to March 2022. We evaluated outcomes of patients who were followed in our clinic at least 6 months post-transplant. Pretransplant patient characteristics, COVID-19-related treatment, histopathology results, and postdischarge course were evaluated. Results. Among a total of 13 lung transplant recipients, 6 consecutive patients were identified who had a minimum of 6 months of follow-up post-lung transplantation. The average age of patients was 55 years, with a male predominance. The median time to transplantation was 111 days. All 6 patients had significant postinfectious complications due to COVID-19 before transplant. Histopathological findings from explanted lungs showed a predominance of fibrotic change. There were no reported cases of rejection or graft dysfunction. 5 patients had minimal to no post-transplant infectious complications. One patient died 218 days post-transplant from infectious complications. Conclusions. Five out of six lung transplant recipients at our institution have demonstrated excellent long-term outcomes after index hospitalization, for a mean follow-up of 13 months post-lung transplantation. Lung transplantation for lung fibrosis due to COVID-19 is an acceptable salvage treatment option. Larger studies are warranted to confirm these findings.
AB - Background. A significant proportion of patients with severe and persistent coronavirus disease 2019 (COVID-19) require continuous ventilatory support and occasional extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). Lung transplantation is a treatment option for patients who develop severe ARDS. Methods. Our lung transplant database was retrospectively reviewed for patients who underwent lung transplantation for COVID-19 pulmonary disease at Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, from January 2020 to March 2022. We evaluated outcomes of patients who were followed in our clinic at least 6 months post-transplant. Pretransplant patient characteristics, COVID-19-related treatment, histopathology results, and postdischarge course were evaluated. Results. Among a total of 13 lung transplant recipients, 6 consecutive patients were identified who had a minimum of 6 months of follow-up post-lung transplantation. The average age of patients was 55 years, with a male predominance. The median time to transplantation was 111 days. All 6 patients had significant postinfectious complications due to COVID-19 before transplant. Histopathological findings from explanted lungs showed a predominance of fibrotic change. There were no reported cases of rejection or graft dysfunction. 5 patients had minimal to no post-transplant infectious complications. One patient died 218 days post-transplant from infectious complications. Conclusions. Five out of six lung transplant recipients at our institution have demonstrated excellent long-term outcomes after index hospitalization, for a mean follow-up of 13 months post-lung transplantation. Lung transplantation for lung fibrosis due to COVID-19 is an acceptable salvage treatment option. Larger studies are warranted to confirm these findings.
KW - ARDS
KW - COVID-19
KW - hospitalization
KW - lung transplantation
KW - outcomes
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U2 - 10.1093/ofid/ofac425
DO - 10.1093/ofid/ofac425
M3 - Article
AN - SCOPUS:85147661832
SN - 2328-8957
VL - 9
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 9
M1 - ofac425
ER -