~7 Percent of Lung Transplants Due to COVID-19 Respiratory Failure

From August 2020 through September 2021, about 7 percent of lung transplantations were performed in patients with COVID-19-related respiratory failure, according to a letter to the editor published online Jan. 26 in the New England Journal of Medicine.

Amy Roach, M.D., from Cedars-Sinai Medical Center in Los Angeles, and colleagues analyzed lung transplantations performed between Aug. 1, 2020, and Sept. 30, 2021, and reported in the United Network for Organ Sharing registry.

The researchers found that 7.0 percent of the 3,039 lung transplantations were performed for COVID-19-related respiratory failure, including 4.6 and 2.4 percent for acute respiratory distress syndrome and pulmonary fibrosis, respectively. Per center, a median of 2.5 lung transplantations were performed for COVID-19-related respiratory failure. Overall, 197 (92.1 percent) and 17 (7.9 percent) of the 214 lung transplantations were bilateral- and single-lung transplantations, respectively. Of the 183 patients with validated data, the median patient age was 52 years, 20.8 percent were female, and 36.6 percent were Hispanic. About half (53.0 percent) received mechanical ventilation preoperatively; 64.5 percent received extracorporeal membrane oxygenation and 4.9 percent underwent dialysis. The median lung allocation score was 87.5. Patients were followed for a median of 1.9 months. There were nine postoperative deaths, with 30-day mortality of 2.2 percent and three-month survival of 95.6 percent.

"Because the three-month survival among these patients approached that among patients who underwent lung transplantation for reasons other than COVID-19, we believe that lung transplantation may be an acceptable treatment for selected patients with irreversible respiratory failure due to COVID-19," the authors write.