Survival High With Lung Transplant for COVID-19-Associated ARDS

MONDAY, Feb. 14, 2022 (HealthDay News) -- Lung transplantation is successful for patients with COVID-19-associated acute respiratory distress syndrome (ARDS), with high survival, according to a study published online Jan. 27 in the Journal of the American Medical Association.

Chitaru Kurihara, M.D., from Northwestern University in Chicago, and colleagues conducted a retrospective case series of 102 patients who underwent a lung transplant between Jan. 21, 2020, and Sept. 30, 2021, including 30 patients with COVID-19-associated ARDS.

The researchers found that the median lung allocation scores were 85.8 versus 46.7 for lung transplant recipients with versus those without COVID-19; median time on the lung transplant waitlist was 11.5 versus 15 days, and 56.7 and 1.4 percent, respectively, used preoperative venovenous extracorporeal membrane oxygenation (ECMO). Patients with COVID-19-associated ARDS received transfusion of a median 6.5 units of packed red blood cells during transplant versus none for those without COVID-19; intraoperative venoarterial ECMO was used by 96.7 and 62.5 percent, respectively, and the median operative time was 8.5 versus 7.4 hours, respectively. The rates of primary graft dysfunction within 72 hours were 70 versus 20.8 percent postoperatively for the COVID-19 cohort versus those without COVID-19; the median time receiving invasive mechanical ventilation was 6.5 versus 2.0 days, and 13.3 and 5.5 percent, respectively, needed permanent hemodialysis. Antibody-mediated rejection was demonstrated by none of those with COVID-19-associated ARDS versus 12.5 percent of those without COVID-19. At follow-up, all COVID-19-associated ARDS lung transplant recipients were alive compared with 83 percent in the non-COVID-19 cohort.

"Due to the inherent uncertainty in prognosis, the progress of each patient needs to be determined longitudinally over time," the authors write.

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