AI Article Synopsis

  • Lung transplantation for patients with end-stage lung disease from COVID-19 is increasingly common, though there is a lack of comprehensive international studies on the subject.
  • In a multicenter analysis involving 11 major lung transplant centers, 46 out of 1606 lung transplants were performed due to COVID-19-related conditions, showing distinct demographic and clinical characteristics compared to other patients.
  • The 30-day survival rates for transplant recipients due to COVID-19 were found to be similar to those without COVID-19, suggesting that lung transplantation is a viable option for select patients suffering from COVID-19-related lung damage.

Article Abstract

Introduction: Lung transplantation has become increasingly utilized in patients with COVID-19. While several single-center and UNOS database studies have been published on lung transplants (LTs) for end-stage lung disease (ESLD) from Coronavirus disease 2019 (COVID-19), there is a lack of multi-center and international data.

Methods: This is a multicenter analysis from 11 high-volume lung transplant centers in the United States and Europe. Data were collected through the Multi-Institutional ECLS Registry and stratified by ESLD due to COVID-19 versus other etiologies. Demographics and clinical variables were compared using Chi-square test and Fisher's exact test. Survival was assessed by Kaplan-Meier curves and compared by log-rank test with propensity score matching.

Results: Of 1606 lung transplant recipients, 46 (2.9%) were transplanted for ESLD from COVID-19 compared to 1560 (97.1%) without a history of COVID-19. Among COVID-19 patients, 30 (65.2%) had COVID-19-associated ARDS and 16 (34.8%) had post-COVID-19 fibrosis. COVID-19 patients had higher lung allocation scores (78.0 vs. 44.4, p < 0.0001), had severely limited functional status (37.0% vs. 2.9%, p < 0.0001), had higher preoperative ECMO usage (65.2% vs. 5.4%, p < 0.0001), and spent less time on the waitlist (32 vs. 137 days, p < 0.0001). A 30-day survival was comparable between COVID-19 and non-COVID-19 patients before (100% vs. 98.7%, p = 0.39) and after propensity matching (p = 0.15).

Conclusions: Patients who received LTs due to COVID-19 had short-term survival comparable to that of patients without COVID-19. Our findings support the idea that lung transplantation should be considered for select patients with ESLD due to COVID-19.

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Source
http://dx.doi.org/10.1111/ctr.15462DOI Listing

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