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Published on: August 15, 2022
A Single-Center Experience with Lung Transplants During the COVID-19 Pandemic
Wojtek Karolak1, Elżbieta Woźniak-Grygiel2, Monika Łącka3
1Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland.
Insights
Lung transplants proceeded effectively despite COVID-19 challenges. Patient qualification and waiting list mortality remained stable, with similar donor criteria and outcomes observed between 2019 and 2020.
Area of Science:
- Cardiology
- Thoracic Surgery
- Transplant Surgery
Background:
- Analysis of lung transplant procedures at a single center in Poland.
- Comparison of pre-pandemic (2019) and pandemic (2020) lung transplantation data.
- Focus on the impact of the COVID-19 pandemic on surgical operations and patient outcomes.
Purpose of the Study:
- To evaluate the differences in lung transplantations performed before and during the COVID-19 pandemic.
- To assess the impact of pandemic-related restrictions on patient qualification and transplant procedures.
- To compare outcomes, including waiting list mortality and post-operative recovery, between the two periods.
Main Methods:
- Retrospective analysis of 189 patients undergoing lung transplant qualification in 2019 and 2020.
- Comparison of 12 lung transplant patients from 2019 (control) with 16 lung transplant patients from 2020 (study group).
- Evaluation of patient qualification numbers, waiting list mortality, donor criteria, transplant types, ventilation time, post-operative complications (e.g., PGD), and ICU stay.
Main Results:
- Despite a 3-month lockdown in 2020, patient qualification processes were only slightly reduced (102 in 2019 vs. 87 in 2020).
- Waiting list mortality remained consistent at 14.3% in both years (4 deaths in 2019, 6 in 2020).
- Donor qualifications and distribution were similar; 2020 saw a shift towards more single-lung transplants (11 double, 5 single) compared to 2019 (all double). Post-operative outcomes like ventilation time and PGD showed no significant difference, with a shorter ICU stay in 2020.
Conclusions:
- Lung transplantation was successfully maintained during the COVID-19 pandemic.
- The pandemic presented organizational challenges but did not significantly compromise the quality or outcomes of lung transplant procedures.
- The study highlights the resilience of transplant programs in adapting to unprecedented public health crises.
Abstract:
BACKGROUND This single-center study analyzed distinctions between lung transplants performed in the Department of Cardiac and Vascular surgery of the University Clinical Center in Gdańsk, Poland before and during the COVID-19 pandemic. MATERIAL AND METHODS There were 189 patients who underwent the qualification procedure to lung transplantation in the Department of Cardiac and Vascular Surgery of the University Clinical Center in Gdańsk, Poland in the years 2019 and 2020. The control group consisted of 12 patients transplanted in 2019, and the study group consisted of 16 patients transplanted in 2020. RESULTS During 2019, the qualification process was performed in 102 patients with pulmonary end-stage diseases. In 2020, despite the 3-month lockdown related to organizational changes in the hospital, 87 qualification processes were performed. The mortality rate of patients on the waiting list in 2020 was 14.3% (6 patients died), and during 2019 the rate was also 14.3% (4 patients died). Donor qualifications were according to ISHLT criteria. The distribution of donors in both years was similar. There was no relationship between the geographic area of residence and source of donors. In 2019, all 12 patients had double-lung transplant. In 2020, 11 patients had double-lung transplant and 5 patients had single-lung transplant. There was no difference in ventilation time and PGD aside from a shorter ICU stay in 2020. CONCLUSIONS Lung transplants were relatively well-conducted despite the continued obstacles of the COVID-19 pandemic.
