Urgently listed lung transplant patients have outcomes similar to those of electively listed patients

Tang, Andrew; Thuita, Lucy; Siddiqui, Hafiz Umair; Rappaport, Jesse; Blackstone, Eugene H.; McCurry, Kenneth R.; Ahmad, Usman; Tong, Michael; Bribriesco, Alejandro; Johnston, Douglas R.; Unai, Shinya; Yun, James; Ahmad, Zeeshan; Murthy, Sudish C.; Budev, Marie

doi:10.1016/j.jtcvs.2020.02.140

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…Compared to propensity matched patients who were electively listed, there was no significant difference in death at one month after LTx, ECMO use, or ICU stay. The survival at one month and 5 year survival of urgently listed patients were comparable to that of published literature [1]. Older patients, liver impairment, and outside hospital transfers were associated with death after urgent listing.…”

supporting

confidence: 77%

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Commentary: “To list, or not to list? That is the question”

Chen

Hsin

2021

The Journal of Thoracic and Cardiovascular Surgery

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supporting

confidence: 77%

“…What is not known was their decision process-who to urgently list, and who to bridge? Further investigation into frailty, sarcopenia and other organ-system dysfunction may improve patient selection [1].…”

mentioning

confidence: 99%

Commentary: “To list, or not to list? That is the question”

Chen

Hsin

2021

The Journal of Thoracic and Cardiovascular Surgery

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“…14 All of the referred patients had extremely high lung allocation scores, revealing a "ceiling" effect of lung allocation scores in capturing high-risk features to stratify urgent listed patients with a high mortality rate related to COVID-19. 15,16 Higher Sequential Organ Failure Assessment scores were also observed in transplant recipients (Table E2). Sequential Organ Failure Assessment scores changed substantially 1 week post-LTx, which indicates a reduced risk of mortality.…”

Section: Discussionmentioning

confidence: 93%

Lung transplantation during the outbreak of Coronavirus Disease 2019 in China

Huang

Jiao

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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Objectives To illustrate our workflow for lung donation and transplantation during the COVID-19 crisis and report our preliminary experience with perioperative care. Methods We retrospectively analyzed data in the China Lung Transplantation Registration from January 23 rd , 2020, to March 23 rd , 2020 (2020 cohort), compared to the same period in 2019 (2019 cohort). Pre- and post-lung transplantation (LTx) management strategies, including measures aiming to prevent SARS-CoV-2 infection, were applied for all recipients, including five post-COVID-19 transplants during the COVID-19 pandemic period in China. Results Twenty-eight LTx procedures were performed, including LTx for five patients with acute respiratory distress syndrome (ARDS) due to COVID-19-related pulmonary fibrosis. Compared to the 2019 cohort, more patients with urgent conditions were transplanted in 2020, with a shorter pre-LTx admission time and early mobilization post-LTx. A large proportion (60%) of lung donations were transported on high-speed trains and commercial flights or commercial flights and highways. Grafts in the preservation containers were handed over to the receiving staff at the airport for 40% (10/25) of donations, which reduced the unnecessary quarantine of transporting staff entering the city. Listed candidates were urgently transferred to other qualified centers in 17.9% (5/28) of cases, which reduced the risk of SARS-CoV-2 exposure in COVID-19 designated hospitals. The 90-day survival rate of the recipients transplanted in 2020 was 85.7%, including 3 of 5 (60%) recipients who were critically severe COVID-19 patients. Conclusion LTx and lung donation amid COVID-19 can be performed safely with coordinated efforts on medical resource sharing and medical staff protection based on stratification of the infection risk. Outcomes were not compromised during the COVID-19 outbreak. LTx can be regarded as salvage therapy for critical COVID-19 patients with a confirmed positive-turned-negative virology status.

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“…Still, Tang and colleagues 7 provide granular characteristics on those patients who not only underwent transplantation but also were listed, which offers those in similar centers an opportunity to reevaluate and potentially improve recipient selection in this high-risk patient population.…”

Section: Central Messagementioning

confidence: 99%

“…Although the study by Tang and colleagues 7 is an interesting and meaningful contribution on the high-risk subset of lung transplant recipients, their conclusions should be interpreted with caution. By propensity matching the urgently and electively listed patients after transplantation, the groups being compared are urgently listed patients who are in acute, fulminant pulmonary failure often with multiorgan dysfunction at the time of presentation, with a minority of electively listed patients who have a high Lung Allocation Score and are further decompensated than most electively listed patients.…”

mentioning

confidence: 95%