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First lung and kidney multi-organ transplant following COVID-19 Infection.

ABSTRACT: As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combined lung and kidney transplantation in a patient with COVID-19. Lung transplantation, isolated or combined with other organs, is feasible and should be considered for select patients impacted by this deadly disease.

SUBMITTER: Guenthart BA

PROVIDER: S-EPMC8088330 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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First lung and kidney multi-organ transplant following COVID-19 Infection.

Guenthart Brandon A BA Krishnan Aravind A Alassar Aiman A Madhok Jai J Kakol Monika M Miller Shari S Cole Sheela Pai SP Rao Vidya K VK Acero Natalia Martinez NM Hill Charles C CC Cheung Cindy C Jackson Ethan C EC Feinstein Igor I Tsai Albert H AH Mooney Joshua J JJ Pham Thomas T Elliott Irmina A IA Liou Douglas Z DZ La Francesca Saverio S Shudo Yasuhiro Y Hiesinger William W MacArthur John W JW Brar Nivaz N Berry Gerald J GJ McCarra Matthew B MB Desai Tushar J TJ Dhillon Gundeep S GS Woo Y Joseph YJ

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 20210502 8

As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combined lung and kidney transplantation in a patient with COVID-19. Lung transplantation, isolated or combined with other organs, is feasible and should be ...[more]

PMID: 34059432

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Project description:ImportanceThe COVID-19 pandemic led to the use of lung transplant as a lifesaving therapy for patients with irreversible lung injury. Limited information is currently available regarding the outcomes associated with this treatment modality.ObjectiveTo describe the outcomes following lung transplant for COVID-19-related acute respiratory distress syndrome or pulmonary fibrosis.Design, setting, and participantsIn this cohort study, lung transplant recipient and donor characteristics and outcomes following lung transplant for COVID-19-related acute respiratory distress syndrome or pulmonary fibrosis were extracted from the US United Network for Organ Sharing database from March 2020 to August 2022 with a median (IQR) follow-up period of 186 (64-359) days in the acute respiratory distress syndrome group and 181 (40-350) days in the pulmonary fibrosis group. Overall survival was calculated using the Kaplan-Meier method. Cox proportional regression models were used to examine the association of certain variables with overall survival.ExposuresLung transplant following COVID-19-related acute respiratory distress syndrome or pulmonary fibrosis.Main outcomes and measuresOverall survival and graft failure rates.ResultsAmong 385 included patients undergoing lung transplant, 195 had COVID-19-related acute respiratory distress syndrome (142 male [72.8%]; median [IQR] age, 46 [38-54] years; median [IQR] allocation score, 88.3 [80.5-91.1]) and 190 had COVID-19-related pulmonary fibrosis (150 male [78.9%]; median [IQR] age, 54 [45-62]; median [IQR] allocation score, 78.5 [47.7-88.3]). There were 16 instances of acute rejection (8.7%) in the acute respiratory distress syndrome group and 15 (8.6%) in the pulmonary fibrosis group. The 1-, 6-, and 12- month overall survival rates were 0.99 (95% CI, 0.96-0.99), 0.95 (95% CI, 0.91-0.98), and 0.88 (95% CI, 0.80-0.94) for the acute respiratory distress syndrome cohort and 0.96 (95% CI, 0.92-0.98), 0.92 (95% CI, 0.86-0.96), and 0.84 (95% CI, 0.74-0.90) for the pulmonary fibrosis cohort. Freedom from graft failure rates were 0.98 (95% CI, 0.96-0.99), 0.95 (95% CI, 0.90-0.97), and 0.88 (95% CI, 0.79-0.93) in the 1-, 6-, and 12-month follow-up periods in the acute respiratory distress cohort and 0.96 (95% CI, 0.92-0.98), 0.93 (95% CI, 0.87-0.96), and 0.85 (95% CI, 0.74-0.91) in the pulmonary fibrosis cohort, respectively. Receiving a graft from a donor with a heavy and prolonged history of smoking was associated with worse overall survival in the acute respiratory distress syndrome cohort, whereas the characteristics associated with worse overall survival in the pulmonary fibrosis cohort included female recipient, male donor, and high recipient body mass index.Conclusions and relevanceIn this study, outcomes following lung transplant were similar in patients with irreversible respiratory failure due to COVID-19 and those with other pretransplant etiologies.

Dataset Information

First lung and kidney multi-organ transplant following COVID-19 Infection.

Publications

First lung and kidney multi-organ transplant following COVID-19 Infection.

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