Surgeons perform first known US double lung transplant on Covid-19 patient who spent six weeks in ICU

The patient, a Hispanic woman in her 20s, underwent a 10-hour surgery Northwestern Memorial Hospital in Chicago

                            Surgeons perform first known US double lung transplant on Covid-19 patient who spent six weeks in ICU
(Northwestern Medicine)

A young Chicago woman, whose lungs were destroyed by the new coronavirus, has received a double lung transplant at the Northwestern Memorial Hospital in Chicago. This makes it the first known lung transplant in the US for Covid-19, according to the hospital. The patient, a Hispanic woman in her 20s, spent six weeks in the intensive care unit (ICU) on a ventilator and extracorporeal membrane oxygenation (ECMO), a life support machine that does the work of the heart and lungs. She underwent a 10-hour-long surgery at the hospital. “For the first time, surgeons at Northwestern Medicine performed a double-lung transplant on a patient whose lungs were damaged by Covid-19,” said the hospital in a statement. 

The surgery offers hope for coronavirus patients who have sustained severe and irreversible lung damage, say health experts. “Covid-19 results in significant damage to the lungs of patients with severe disease. Opening the door to patients who have recovered from the infection to lung transplantation offers a potential path to recovery,” said Dr Michael Ison, infectious diseases and organ transplantation specialist at Northwestern Medicine. The woman was admitted to the hospital on April 26, following which her condition kept worsening. By early June, the patient’s lungs showed irreversible damage. The lung transplant team listed her for a double-lung transplant, and 48 hours later, performed the life-saving procedure at Northwestern Memorial Hospital. But before putting the patient on the transplant wait-list, she had to test negative for Covid-19. 

“For many days, she was the sickest person in the Covid ICU – and possibly the entire hospital,” said Dr Beth Malsin, pulmonary and critical care specialist at Northwestern Memorial Hospital. She explained, “There were so many times, day and night, our team had to react quickly to help her oxygenation and support her other organs to make sure they were healthy enough to support a transplant if and when the opportunity came. One of the most exciting times was when the first coronavirus test came back negative and we had the first sign she may have cleared the virus to become eligible for a life-saving transplant.”

Patient's lung damaged by Covid-19 (Northwestern Medicine)

According to the doctors, a lung transplant was her only chance of survival. The surgery was performed on Friday last week and the patient is now recovering in intensive care. “We are one of the first health systems to successfully perform a lung transplant on a patient recovering from Covid-19. We want other transplant centers to know that while the transplant procedure in these patients is quite technically challenging, it can be done safely, and it offers the terminally ill Covid-19 patients another option for survival,” said Dr Ankit Bharat, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program. 

Dr Bharat said that the woman had no serious underlying medical conditions, she is in a stable condition and improving every day. “Yesterday, the patient smiled and told me, ‘Thank you for not giving up on me.’ As healthcare providers, there’s nothing more gratifying to hear. This is why we do what we do,” he said on June 11. The medical team, however, said that the woman still has a long and potentially risky road to recovery given how sick she was with multi-organ dysfunction for weeks preceding the transplant. “We hope she will make a full recovery,” said Dr Rade Tomic, a pulmonologist and medical director of the hospital’s lung transplant program.

According to Dr Tomic, during her stay in ICU meant for coronavirus patients at Northwestern Memorial Hospital, while her body cleared the virus, her lungs were damaged beyond repair. “How did a healthy woman in her 20s get to this point? There’s still so much we have yet to learn about Covid-19. Why are some cases worse than others? The multidisciplinary research team at Northwestern Medicine is trying to find out,” he said. Dr Tomic said that Northwestern Medicine has one of the shortest wait-times in the US for new lungs. Once a patient’s name is added to the transplant waiting list, it typically takes 30 days to find a match, which is much shorter than the national average of three months. “The fact that we were able to transplant this patient quickly and safely, is a testament to the infrastructure and expertise of our clinical care and research teams,” he added.

This is not the first time doctors have used lung transplantation to save a coronavirus patient. Doctors in Vienna said a 45-year-old woman whose lungs were “damaged beyond repair” became the first European patient to survive that operation. According to a statement by the hospital, the woman developed severe respiratory failure eight weeks after contracting the virus. “The Department of Surgery of MedUni Vienna/Vienna General Hospital carried out an urgent and highly complex lung transplant on a 45-year-old woman from Carinthia, who has developed severe respiratory failure as a result of Covid-19. The team successfully replaced the patient's lungs, which had been damaged beyond repair, with new donor lungs,” said a May 25 statement. 

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