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Lung Transplantation in the United States for COVID-19 Related Lung Disease During the Pandemic (2597/2600)

  • RESEARCH
  • LUNG TRANSPLANTATION IN COVID-19
  • Published:
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Abstract

Purpose

Lung transplantation (LTx) is a potential intervention for end-stage COVID-19 lung disease. Current literature is sparse regarding the outcomes of LTx for COVID-19 related acute respiratory distress syndrome (ARDS) and pulmonary fibrosis (PF). This study aims to characterize outcomes and patterns of LTx for COVID-19 related lung disease throughout the pandemic.

Methods

Patients who underwent LTx during the pandemic for COVID-19 related lung disease were retrospectively identified using the UNOS registry. Demographics, as well as outcomes measures and nationwide patterns of care were collected and analyzed.

Results

A total of 510 adult cases of LTx for COVID-19 (259 ARDS, 251 PF) were compared to 4,031 without COVID-19 (3,994 PF, 37 ARDS). Patients who received LTx for COVID-19 ARDS did not differ in 2-year survival when compared to those with COVID-19 PF (81.9% vs 77.2%, p = 0.4428). Compared to non-COVID-19 etiologies, COVID-19 ARDS patients had higher rates of stroke (2.3% vs 0%, p = 0.0005), lower rates of graft failure (12.8% vs 36.1%, p = 0.0003) and post-transplant ECMO (29.6% vs 41.7%, p = 0.0002), and improved 2-year survival following LTx (81.9% vs 61.7%, p = 0.0064). No difference in 2-year survival following LTx was observed between patients with COVID-19 and non-COVID-19 PF (77.2% vs 71.8%, p = 0.34). Rates of LTx spiked with variant emergence and declined with rounds of vaccination.

Conclusion

Our results are consistent with early reports of survival outcomes following LTx for COVID-19 ARDS and PF while providing an increased layer of granularity. LTx may be considered as a safe and effective intervention for COVID-19 lung disease.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA

    Mikayla D’Cunha, J. Asher Jenkins, Renita Wilson, Juan Maria Farina, Cecilia Benz, Jonathan D’Cunha & Pedro Augusto Reck Dos Santos

  2. Division of Pulmonology and Critical Care, Mayo Clinic Arizona, Phoenix, AZ, USA

    Ashraf Omar

  3. Division of Clinical Trials and Biostatistics, Mayo Clinic Arizona, Scottsdale, AZ, USA

    Blake Langlais

Authors
  1. Mikayla D’Cunha
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  2. J. Asher Jenkins
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  3. Renita Wilson
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  4. Juan Maria Farina
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  5. Ashraf Omar
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  6. Blake Langlais
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  7. Cecilia Benz
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  8. Jonathan D’Cunha
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  9. Pedro Augusto Reck Dos Santos
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Blake Langlais. The first draft of the manuscript was written by Mikayla D’Cunha, J. Asher Jenkins, and Pedro Augusto Reck Dos Santos, and all authors have read, edited, provided suggestions as necessary, and approved the final manuscript.

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Correspondence to Pedro Augusto Reck Dos Santos.

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D’Cunha, M., Jenkins, J.A., Wilson, R. et al. Lung Transplantation in the United States for COVID-19 Related Lung Disease During the Pandemic (2597/2600). Lung (2024). https://doi.org/10.1007/s00408-024-00724-z

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