Oxford University Press, Clinical Infectious Diseases, 2023
DOI: 10.1093/cid/ciad072
Full text: Download
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.