Lung transplantation for acute COVID-19: the Toronto Lung Transplant Program experience

Yeung, Jonathan; Cypel, Marcelo; Chaparro, Cecilia; Keshavjee, S.

doi:10.1503/cmaj.211143

Cited by 19 publications

(16 citation statements)

References 10 publications

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“…In most reported cases transplant has been performed in individuals under 65 years of age with single organ dysfunction (lungs) and after allowing enough time for lung recovery [ 10 , 15 ]. Most cases have been performed off ECMO ( Table 2 ) [ [4] , [5] , [6] , 8 , 9 ]. Rehabilitation potential prior to acute illness must be present.…”

Section: Discussionmentioning

confidence: 99%

“…The first report in March 2020 described three Chinese patients that underwent successful bilateral LT for COVID-19 ARDS [ 4 ]. Others reported on their experience from centers in China, United States, Canada, Italy, Austria, and India [ [4] , [5] , [6] , [7] , [8] , [9] ]. The largest single center in the United States described 100% survival at 30-days post-bilateral LT for COVID-19 ARDS in 3 patients [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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A center experience with lung transplantation for COVID-19 ARDS

Franco-Palacios

Allenspach

Stagner

et al. 2022

Respiratory Medicine Case Reports

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COVID-19 can cause irreversible lung damage from acute respiratory distress syndrome (ARDS), chronic respiratory failure associated with post COVID-19 de novo fibrosis or worsening of an underlying fibrotic lung disease. Pregnant women are at increased risk for invasive mechanical ventilation, extracorporeal membrane oxygenation, and death. The Centers for Disease Control and Prevention reported more than 22,000 hospitalizations and 161 deaths for COVID-19 in pregnant women. Between August 2020 and September 2021, five patients underwent bilateral lung transplant (LT) for COVID-19 ARDS at the Henry Ford Hospital in Detroit, Michigan. De-identified demographics data, clinical characteristics, perioperative challenges, explanted lung pathology, and post-transplant outcomes are described. In post-hospitalization follow-up (median survival 273 days), we see improving endurance and excellent lung function. One patient did not survive to hospital discharge and succumbed to complications 5 months after LT. We report the first cases of bilateral LT in two postpartum women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A center experience with lung transplantation for COVID-19 ARDS

Franco-Palacios

Allenspach

Stagner

et al. 2022

Respiratory Medicine Case Reports

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“…In contrast, decline in MDR rates for the entire hospital was reported in an Italian hospital [ 111 ]. Lung transplantation has emerged as a long-term solution for COVID-19 patients with non-reversible lung fibrosis [ 112 – 114 ]. Since these patients have had heavy exposure to the healthcare environment and high pretransplant infection rates, MDR rates in this population is potentially higher than non-COVID lung recipients [ 112 ].…”

Section: Impact Of the Covid-19 Global Pandemic On Antimicrobial Resi...mentioning

confidence: 99%

“…Since these patients have had heavy exposure to the healthcare environment and high pretransplant infection rates, MDR rates in this population is potentially higher than non-COVID lung recipients [ 112 ]. Although short-term outcome seems similar in the limited literature when compared to lung transplant for other indications, long-term data are missing and most studies did not specifically report on infections in the posttransplant period [ 112 , 114 ]. The overall effect of the pandemic on AMR remains to be determined.…”

Section: Impact Of the Covid-19 Global Pandemic On Antimicrobial Resi...mentioning

confidence: 99%

Challenges of Antimicrobial Resistance and Stewardship in Solid Organ Transplant Patients

Walti

2022

Curr Infect Dis Rep

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Purpose of Review Without effective antimicrobials, patients cannot undergo transplant surgery safely or sustain immunosuppressive therapy. This review examines the burden of antimicrobial resistance in solid organ transplant recipients and identifies opportunities for antimicrobial stewardship. Recent Findings Antimicrobial resistance has been identified to be the leading cause of death globally. Multidrug-resistant pathogens are associated with significant morbidity and mortality in transplant recipients. Methicillin-resistant S. aureus affects liver and lung recipients, causing bacteremia, pneumonia, and surgical site infections. Vancomycin-resistant enterococci is a nosocomial pathogen primarily causing bacteremia in liver recipients. Multidrug-resistant Gram-negative pathogens present urgent and serious threats to transplant recipients. Extended-spectrum beta-lactamase-producing E. coli and K. pneumoniae commonly cause bacteremia and intra-abdominal infections in liver and kidney recipients. Carbapenemase-producing Enterobacterales, mainly K. pneumoniae , are responsible for infections early-post transplant in liver, lung, kidney, and heart recipients. P. aeruginosa and A. baumannii continue to be critical threats. While there are new antimicrobial agents targeting resistant pathogens, judicious prescribing is crucial to minimize emerging resistance. The full implications of the COVID-19 global pandemic on antimicrobial resistance in transplant recipients remain to be understood. Currently, there are no established standards on the implementation of antimicrobial stewardship interventions, but strategies that leverage existing antimicrobial stewardship program structure while tailoring to the needs of transplant recipients may help to optimize antimicrobial use. Summary Clinicians caring for transplant recipients face unique challenges tackling emerging antimcirobial resistance. Coordinated antimicrobial stewardship interventions in collaboration with appropriate expertise in transplant and infectious diseases may mitigate against such threats.

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“…Lung transplantation for COVID-ESLD is feasible, 4 , 5 with favorable short-term outcomes. 6 The suggested criteria for lung transplantation in COVID-ESLD are evolving and include age <65 years, isolated and irreversible lung dysfunction, and a negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test.…”

mentioning

confidence: 99%