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A Multi-Center International Analysis of Lung Transplantation Outcomes in Patients With COVID-19

Mohammed Abul Kashem1, Gabriel Loor2, Amir Emtiazjoo3

  • 1Division of Cardiovascular Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

Clinical Transplantation
|September 24, 2024
PubMed

Insights

Lung transplantation for end-stage lung disease from COVID-19 shows comparable short-term survival to other causes. This supports considering lung transplants for select COVID-19 patients.

Area of Science:

  • Medicine
  • Pulmonology
  • Transplant Surgery

Background:

  • Lung transplantation (LT) is increasingly used for COVID-19 patients.
  • Existing studies on LT for COVID-19 related end-stage lung disease (ESLD) are limited to single-center or national data.
  • There is a need for multi-center and international data on LT for COVID-19 ESLD.

Purpose of the Study:

  • To compare outcomes of lung transplantation in patients with end-stage lung disease (ESLD) due to COVID-19 versus other etiologies.
  • To assess the feasibility and short-term survival of lung transplantation for COVID-19 survivors.

Main Methods:

  • A multicenter analysis involving 11 high-volume lung transplant centers in the US and Europe.
  • Data collected from the Multi-Institutional ECLS Registry, stratified by COVID-19 ESLD and other causes.
  • Statistical comparison using Chi-square, Fisher's exact, Kaplan-Meier, log-rank tests, and propensity score matching.

Main Results:

  • Out of 1606 lung transplant recipients, 46 (2.9%) had ESLD from COVID-19.
  • COVID-19 patients had higher lung allocation scores, limited functional status, and increased preoperative ECMO use.
  • Thirty-day survival was comparable between COVID-19 and non-COVID-19 groups, both before and after propensity matching.

Conclusions:

  • Lung transplantation for COVID-19-related ESLD demonstrates short-term survival rates similar to non-COVID-19 recipients.
  • These findings suggest that lung transplantation is a viable option for carefully selected patients with severe COVID-19 lung disease.
Abstract

Keywords:
fibrosislung (allograft) function/dysfunctionlung (native) function/dysfunctionpatient survival

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