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Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis

Authors :
Jing-Yu Chen
Kun Qiao
Feng Liu
Bo Wu
Xin Xu
Guo-Qing Jiao
Rong-Guo Lu
Hui-Xing Li
Jin Zhao
Jian Huang
Yi Yang
Xiao-Jie Lu
Jia-Shu Li
Shu-Yun Jiang
Da-Peng Wang
Chun-Xiao Hu
Gui-Long Wang
Dong-Xiao Huang
Guo-Hui Jiao
Dong Wei
Shu-Gao Ye
Jian-An Huang
Li Zhou
Xiao-Qin Zhang
Jian-Xing He
Yuan-Yuan Ji
Source :
Chinese Medical Journal, Vol 133, Iss 12, Pp 1390-1396 (2020)
Publication Year :
2020
Publisher :
Wolters Kluwer, 2020.

Abstract

Abstract. Background. Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients. Methods. From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores. Results. Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation. Conclusions. LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.

Subjects

Subjects :
Medicine

Details

Language :
English
ISSN :
03666999, 25425641, and 00000000
Volume :
133
Issue :
12
Database :
Directory of Open Access Journals
Journal :
Chinese Medical Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.9de52c961f1f4cfa81cf73142ecf9810
Document Type :
article
Full Text :
https://doi.org/10.1097/CM9.0000000000000839