1-Year Outcomes of Lung Transplantation for Coronavirus Disease 2019-Associated End-Stage Lung Disease in the United States

Authors

Kenji Okumura, Department of Surgery, Westchester Medical Center/New York Medical College, New York, New York, USA.
Soma Jyothula, Center for Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, UT Health Houston, Houston, Texas, USA.
Thomas Kaleekal, Department of Pulmonary Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abhay Dhand, Department of Surgery, Westchester Medical Center/New York Medical College, New York, New York, USA.Follow

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1093/cid/ciad072

Journal Title

Clinical Infectious Diseases

First Page

2140

Last Page

2147

Document Type

Article

Publication Date

6-16-2023

Department

Medicine

Abstract

BACKGROUND: Lung transplantation can provide quality of life and survival benefits for patients with coronavirus disease 2019 (COVID-19)-associated end-stage lung disease. Characteristics and outcomes of these lung transplant recipients are limited to mostly single-center experiences or provide a short-term follow-up. METHODS: Characteristics of deceased donors and adult lung transplant recipients for COVID-19-associated end-stage lung disease between August-2020 and June-2022 were analyzed using deidentified United Network for Organ Sharing database. Post-transplant patient survival of COVID-19 recipients was analyzed and compared with non-COVID-19 recipients. Secondary outcomes were length of hospitalization, post-transplant complications, and rates of organ rejection. RESULTS: During the study period, 400 lung transplants for COVID-associated end-stage lung disease comprised 8.7% of all lung transplants performed in United States. In the COVID-19 group, Hispanic males received lung transplants at significantly higher rates. The COVID-19 group was younger and had greater need for intensive care unit stay, mechanical ventilation, hemodialysis, extracorporeal membrane oxygenation support, and receipt of antibiotics pre-lung transplant. They had higher lung allocation score, with a shorter wait-list time and received more double lung transplants compared with non-COVID-19 recipients. Post-transplant, the COVID-19 cohort had longer hospital stays, with similar 1-year patient survival (COVID, 86.6% vs non-COVID, 86.3%). Post-transplant, COVID-19-associated deaths were 9.2% of all deaths among lung transplant recipients. CONCLUSIONS: Lung transplantation offers a effective option for carefully selected patients with end-stage lung disease from prior COVID-19, with short-term and long-term outcomes similar to those for lung transplant recipients of non-COVID-19 etiology.

Recommended Citation

Okumura, K., Jyothula, S., Kaleekal, T., & Dhand, A. (2023). 1-Year Outcomes of Lung Transplantation for Coronavirus Disease 2019-Associated End-Stage Lung Disease in the United States. Clinical Infectious Diseases, 76 (12), 2140-2147. https://doi.org/10.1093/cid/ciad072