A Multi-Center International Analysis of Lung Transplantation Outcomes in Patients With COVID-19.

dc.contributor.author

Kashem, Mohammed Abul

dc.contributor.author

Loor, Gabriel

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Emtiazjoo, Amir

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Hartwig, Matthew

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Van Raemdonck, Dirk

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Calvelli, Hannah

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Leon Pena, Andres

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Salan-Gomez, Marcelo

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Zhao, Huaqing

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Warnick, Michael

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Villavicencio, Mauricio

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Ius, Fabio

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Ghadimi, Kamrouz

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Salman, Jawad

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Chandrashekaran, Satish

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Machuca, Tiago

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Sanchez, Pablo G

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Subramaniam, Kathirvel

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Neyrinck, Arne

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Huddleston, Stephen

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Ceulemans, Laurens

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Osho, Asishana

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D'Silva, Ethan

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Ramamurthy, Uma

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Shaffer, Andrew

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Langer, Nathaniel

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Toyoda, Yoshiya

dc.date.accessioned

2024-12-08T19:50:49Z

dc.date.available

2024-12-08T19:50:49Z

dc.date.issued

2024-09

dc.description.abstract

Introduction

Lung transplantation has become increasingly utilized in patients with COVID-19. While several single-center and UNOS database studies have been published on lung transplants (LTs) for end-stage lung disease (ESLD) from Coronavirus disease 2019 (COVID-19), there is a lack of multi-center and international data.

Methods

This is a multicenter analysis from 11 high-volume lung transplant centers in the United States and Europe. Data were collected through the Multi-Institutional ECLS Registry and stratified by ESLD due to COVID-19 versus other etiologies. Demographics and clinical variables were compared using Chi-square test and Fisher's exact test. Survival was assessed by Kaplan-Meier curves and compared by log-rank test with propensity score matching.

Results

Of 1606 lung transplant recipients, 46 (2.9%) were transplanted for ESLD from COVID-19 compared to 1560 (97.1%) without a history of COVID-19. Among COVID-19 patients, 30 (65.2%) had COVID-19-associated ARDS and 16 (34.8%) had post-COVID-19 fibrosis. COVID-19 patients had higher lung allocation scores (78.0 vs. 44.4, p < 0.0001), had severely limited functional status (37.0% vs. 2.9%, p < 0.0001), had higher preoperative ECMO usage (65.2% vs. 5.4%, p < 0.0001), and spent less time on the waitlist (32 vs. 137 days, p < 0.0001). A 30-day survival was comparable between COVID-19 and non-COVID-19 patients before (100% vs. 98.7%, p = 0.39) and after propensity matching (p = 0.15).

Conclusions

Patients who received LTs due to COVID-19 had short-term survival comparable to that of patients without COVID-19. Our findings support the idea that lung transplantation should be considered for select patients with ESLD due to COVID-19.
dc.identifier.issn

0902-0063

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1399-0012

dc.identifier.uri

https://hdl.handle.net/10161/31783

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Clinical transplantation

dc.relation.isversionof

10.1111/ctr.15462

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

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Treatment Outcome

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Lung Transplantation

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Registries

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Survival Rate

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Retrospective Studies

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Adult

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Aged

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Middle Aged

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United States

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Europe

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Female

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Male

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COVID-19

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SARS-CoV-2

dc.title

A Multi-Center International Analysis of Lung Transplantation Outcomes in Patients With COVID-19.

dc.type

Journal article

duke.contributor.orcid

Hartwig, Matthew|0000-0001-8393-2791

duke.contributor.orcid

Ghadimi, Kamrouz|0000-0002-9287-7541

pubs.begin-page

e15462

pubs.issue

9

pubs.organisational-group

Duke

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Pratt School of Engineering

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School of Medicine

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Clinical Science Departments

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Biomedical Engineering

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Anesthesiology

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Anesthesiology, Cardiothoracic

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Surgery

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Surgery, Cardiovascular and Thoracic Surgery

pubs.publication-status

Published

pubs.volume

38

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