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Oxford University Press, Clinical Infectious Diseases, 2023

DOI: 10.1093/cid/ciad072

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

Journal article published in 2023 by Kenji Okumura ORCID, Soma Jyothula ORCID, Thomas Kaleekal ORCID, Abhay Dhand ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

AbstractBackgroundLung 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.MethodsCharacteristics 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.ResultsDuring 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.ConclusionsLung 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.