Abstract
Background: Lung transplantation (LT) is the gold standard for various end-stage chronic lung diseases and could be a salvage therapeutic option in acute respiratory distress syndrome (ARDS). However, LT is uncertain in patients with coronavirus disease 2019 (COVID-19)-related ARDS who failed to recover despite optimal management including extracorporeal membrane oxygenation (ECMO). This study aims to describe the pooled experience of LT for patients with severe COVID-19-related ARDS in Korea.
Methods: A nationwide multicenter retrospective observational study was performed with consecutive LT for severe COVID-19-related ARDS in South Korea (June 2020-June 2021). Data were collected and compared with other LTs after bridging with ECMO from the Korean Organ Transplantation Registry.
Results: Eleven patients with COVID-19-related ARDS underwent LT. The median age was 60.0 years [interquartile range (IQR), 57.5-62.5; six males]. All patients were supported with venovenous ECMO at LT listing and received rehabilitation before LT. Patients were transplanted at a median of 49 (IQR, 32-66) days after ECMO cannulation. Primary graft dysfunction within 72 h of LT developed in two (18.2%). One patient expired 4 days after LT due to sepsis and one patient underwent retransplantation for graft failure. After a median follow-up of 322 (IQR, 299-397) days, 10 patients are alive and recovering well. Compared with other LTs after bridging with ECMO ( n = 27), post-transplant outcomes were similar between the two groups.
Conclusions: LT in patients with unresolving COVID-19-related ARDS were effective with reasonable short-term outcome.
Keywords: COVID-19; extracorporeal membrane oxygenations; frailty; lung transplantation; treatment outcome.
【저자키워드】 COVID-19, frailty, Treatment outcome., lung transplantation, extracorporeal membrane oxygenations, 【초록키워드】 coronavirus disease, ARDS, Treatment outcome, lung, rehabilitation, Sepsis, outcome, extracorporeal membrane oxygenation, management, Patient, ECMO, membrane, Follow-up, multicenter, registry, South Korea, Korean, acute respiratory distress, retrospective, chronic lung disease, transplantation, therapeutic option, dysfunction, two groups, gold standard, median age, one patient, syndrome, effective, collected, was performed, supported, median, expired, IQR, 【제목키워드】 ARDS,