Science & Technology

First double lung transplant performed after irreparable COVID-19 respiratory injury

A 61-year-old patient suffered severe postoperativelyCOVID-19 (new coronavirus infection) Respiratory failure after 3 months with artificial lungs that oxygenate blood, and multiple treatment-related complications.

A Lisbon doctor said in a case report presented at Euroanaesthesia, the annual meeting of the European Society of Anesthesia, a case of a 61-year-old man who underwent a double lung transplant after irreparable lung damage due to COVID-19. I am reporting about. Intensive Care (ESAIC) was held online December 17-19 this year.

The patient was infected with COVID-19 in January 2021 and was discharged on August 23, when Centro Hospitalar Universitário Lisboa Central succeeded in lung transplantation for the first time in COVID-19 survivors.

A man with a history of dyslipidemia (abnormally high levels of cholesterol and other fats in the blood) and gastritis (inflammation of the inner wall of the stomach) was admitted to the emergency department. SARS-CoV-2 Pneumonia on January 12, 2021.

Despite support from the ventilator, he developed extracorporeal membrane oxygenation (ECMO), an advanced lung support therapy that is exacerbated by severe shortness of breath due to low oxygen levels and fully inherits lung function. I needed it. He spent 74 days on ECMO before switching to Extracorporeal Carbon Dioxide Removal (ECCO2R). It is a device designed to remove carbon dioxide, but does not supply very high levels of oxygen.

During the last three months, he has had multiple infections such as pneumonia and prostatic inflammation (swelling of the prostate), as well as a life-threatening reaction to blood coagulopathy (ECMO-related coagulopathy) and the anticoagulant heparin. Suffering from blood complications (heparin-induced thrombocytopenia).

“Approximately 75% of the patient’s lungs were injured by COVID-19, and his scan revealed that his lungs were permanently damaged and did not heal,” said Dr. Anesthesiologist at Centro Hospitalar Universitário Lisboa Central. Carolina Almeida says. I was part of the team that did the transplant. “The patient was eligible for a transplant because he was strong enough to survive a young and dangerous procedure and other organs were not affected by COVID-19. After careful clinical evaluation, he was eligible for a transplant. He received a life-saving organ in May. “

The surgery took about 7 hours and required intensive care for 2 weeks after surgery.

Recovery journey

Six months after the transplant, his recovery is by no means complete. His lung function is good and does not require oxygen support during the day, but recovery processes such as atrial fibrillation (irregular heart rhythm), lung collapse, and subcutaneous emphysema (air is trapped underneath). I had to overcome many challenges. Skin), type 2 diabetes, and some infections.

He continues to undergo rehabilitation to improve mobility, lung function, and quality of life and needs to take more than 12 medications for the rest of his life to prevent organ rejection and infections.

“The team is very grateful that the surgery was very successful and the patient returned home to continue rehabilitation near the family,” said a senior anesthesiologist at Centro Hospitalar Universitário Lisboa Central, who assisted in performing the transplant. One Dr. Lurdes Castro says. “It takes a great deal of willpower to overcome everything he has endured, and it is great to have contributed to giving this patient the opportunity to live again and return to his family and previous life.”

The first small case series after lung transplantation for severe COVID-19 was published in May 2021. It’s strong enough to undergo major transplant surgery, “says Dr. Almeida. “But given the impact of COVID-19 worldwide and the growing number of young and healthy patients affected, the number of transplant candidates could increase significantly. , The lungs may increase to include COVID-19 survivors, which can deteriorate over time. “

First double lung transplant performed after irreparable COVID-19 respiratory injury First double lung transplant performed after irreparable COVID-19 respiratory injury

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