US Woman With Covid-19 Receives Double Lung Transplant

August 13, 2020

A young US patient with COVID-19 has undergone a double lung transplant for the first time after the coronavirus ravaged her lungs.

According to a statement from Northwestern Medicine, the patient, a Hispanic woman in her 20s, spent six weeks in the intensive care unit at Northwestern Memorial Hospital in Chicago after she developed severe COVID-19. She was hooked up to a ventilator and an extracorporeal membrane oxygenation (ECMO) machine to keep her heart and lungs going.

But by early June, she had irreversible damage to her lungs and was placed on the waiting list for a double-lung transplant, according to the statement. Double-lung transplants – in which both lungs are replaced by healthy lungs from a deceased donor – were first performed in the 1960s, but didn’t become widespread until the 1990s, according to Harvard Medical School.

Although survival rates have improved over time, lung transplants are still “very dangerous” compared to kidney or heart transplants, according to Harvard. This was the first time the procedure was performed on a patient with COVID-19, a disease caused by SARS-CoV-2.

However, according to the statement, the patient must test negative for the virus before she undergoes the procedure. (Lung transplants are not usually given to people with active infections, according to the Mayo Clinic. That’s because patients must take immunosuppressive medications after surgery).

“On many days, she was the sickest person in the COVID ICU – and possibly the entire hospital,” said Dr. Beth Malsin, a pulmonary and critical care specialist at Northwestern Memorial Hospital, in a statement.” There were so many times, day and night, that our team had to respond quickly to help with her oxygenation and to 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 moments was when the first coronavirus test came back negative and we had the first indication that she may have cleared the virus and be eligible for a life-saving transplant.” She added.

The surgery took 10 hours, several hours longer than normal, because the inflammation caused by COVID-19 left her lungs “completely attached” to the surrounding tissue, heart, chest wall and diaphragm, Dr. Ankit Bharat, chief of thoracic surgery at Northwestern Medicine and surgical director of the lung transplant program, told The New York Times. Her lung damage was one of the worst he had ever seen.

He told the Times that the woman had no serious underlying medical conditions. However, she is taking a drug that suppresses her immune system to treat minor ailments, he said. But it’s unclear whether the drug made her more susceptible to the virus.

Barratt told Time magazine that she’s recovering well.” She’s awake, she’s smiling, she’s FaceTiming with her family,” but he said it will take some time for her to recover and she is still on a ventilator. Barratt told the Times that she is now taking medication that suppresses her immune system to stop her body from rejecting her lungs, which can increase the risk of infection.

But the patient has undergone several tests to see if the drugs reactivate the coronavirus, and those tests have come back negative, according to the Times.

“A lung transplant is her only chance of survival,” Bharat said in a statement.” We want other transplant centers to know that while transplantation for these patients is quite technically challenging, it can be done safely and it provides another survival option for terminally ill COVID-19 patients.”

The statement said that more than 85 to 90 percent of patients survive for a year after a lung transplant and are able to function independently in their daily lives.

“How did a healthy woman in her 20s get to this point? There’s still a lot we don’t know about COVID-19,” Dr. Rade Tomic, a pulmonologist and medical director of the lung transplant program at Northwestern Medicine, said in the statement.