A Hispanic 20-year-old coronavirus patient in the U.S. was first to receive a double-lung transplant after spending two months in the hospital. Northwestern Medicine released a statement on Thursday, June 11, as reported by Live Science. The patient has been in the intensive care unit at Northwestern Memorial Hospital (NMH) in Chicago for six weeks after acquiring severe COVID-19.
Doctors attached a ventilator and an extracorporeal membrane oxygenation (ECMO) machine to keep her heart and lungs going. However, her lungs showed irreversible damage earlier this month. She was placed on the waiting list for a double-lung transplant, according to the statement.
COVID-19 infection did not hamper first double-lung transplant
Last year, almost 40,000 organ transplants were performed in the U.S., but only 7% of that number was performed on lungs which are hard to find. Patients on the transplant list often wait for weeks to find a donor.
According to Harvard Medical School, double-lung transplants were first performed in the 1960s, replacing both lungs with healthy ones from donors who just died. However, the procedure did not spread until the 1990s because of the risks and costs it entails. It is still riskier than kidney or heart transplants despite improvements in survival rates.
The Hispanic woman is the COVID-19 patient to undergo the double lung transplant procedure.
Since surgeries are not performed on patients with active infections, the statement said that the patient had to test negative for coronavirus before undergoing the procedure since she must take immune-suppressing drugs after the operation.
"For many days, she was the sickest person in the COVID ICU - and possibly the entire hospital," NMH pulmonary and critical care specialist Dr. Beth Malsin said in the statement.
She added that the team attending the patient had to help "her oxygenation and support her other organs to make sure they were healthy enough to support a transplant" when the donors became available.
"One of the most exciting times was when the first coronavirus test came back negative and we had the first sign she may have cleared the virus to become eligible for a life-saving transplant," Dr. Malsin said.
A 10-hour double lung transplant for the worst lungs
The patient spent 10 hours on the operation table as surgeons replaced her lungs. The procedure is much longer than a normal surgery because COVID-19 caused her lungs to be "completely plastered" to the surrounding tissue, heart, chest wall, and the diaphragm.
Dr. Ankit Bharat, NMH Chief of Thoracic Surgery and Surgical Director of the lung transplant program told The New York Times that it was one of the worst lung damages he had seen.
PRESS CONFERENCE will begin at 12 p.m. CST, announcing the first double-lung transplant performed on a #COVID19 patient @NorthwesternMed. @AnkitBharatMD, Beth Malsin, MD, @DrGarzaC and @MichaelIsonMD will speak. To join the event via #Zoom, send us a DM. #COVIDLungTransplant pic.twitter.com/TlYE3tGSRs — NM Media Relations (@NMHC_News) June 11, 2020
Bharat also told the publication that the patient is now recovering. "She's awake, she's smiling, she FaceTimed with her family." She is currently on a ventilator and her recovery will take some time.
The patient is taking immune system suppressing drugs to prevent the body from rejecting the lungs. She also tested negative for COVID-19 for few times as doctors check whether the drugs have reactivated the coronavirus.
"A lung transplant was her only chance for survival," said Bharat. Currently, about 85% to 90% of patients survive lung transplants and can function independently in daily life.
"How did a healthy woman in her 20s get to this point? There's still so much we have yet to learn about COVID-19," Dr. Rade Tomic, a pulmonologist and medical director of the Lung Transplant Program at Northwestern Medicine said in the statement.
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