TY - JOUR
T1 - Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
AU - Levy, Liran
AU - Deri, Ofir
AU - Huszti, Ella
AU - Nachum, Eyal
AU - Ledot, Stephane
AU - Shimoni, Nir
AU - Saute, Milton
AU - Sternik, Leonid
AU - Kremer, Ran
AU - Kassif, Yigal
AU - Zeitlin, Nona
AU - Frogel, Jonathan
AU - Lambrikov, Ilya
AU - Matskovski, Ilia
AU - Chatterji, Sumit
AU - Seluk, Lior
AU - Furie, Nadav
AU - Shafran, Inbal
AU - Mass, Ronen
AU - Onn, Amir
AU - Raanani, Ehud
AU - Grinberg, Amir
AU - Levy, Yuval
AU - Afek, Arnon
AU - Kreiss, Yitshak
AU - Kogan, Alexander
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/6
Y1 - 2023/6
N2 - Severe respiratory failure caused by COVID-19 often requires mechanical ventilation, including extracorporeal membrane oxygenation (ECMO). In rare cases, lung transplantation (LTx) may be considered as a last resort. However, uncertainties remain about patient selection and optimal timing for referral and listing. This retrospective study analyzed patients with severe COVID-19 who were supported by veno-venous ECMO and listed for LTx between July 2020 and June 2022. Out of the 20 patients in the study population, four who underwent LTx were excluded. The clinical characteristics of the remaining 16 patients were compared, including nine who recovered and seven who died while awaiting LTx. The median duration from hospitalization to listing was 85.5 days, and the median duration on the waitlist was 25.5 days. Younger age was significantly associated with a higher likelihood of recovery without LTx after a median of 59 days on ECMO, compared to those who died at a median of 99 days. In patients with severe COVID-19-induced lung damage supported by ECMO, referral to LTx should be delayed for 8–10 weeks after ECMO initiation, particularly for younger patients who have a higher probability of spontaneous recovery and may not require LTx.
AB - Severe respiratory failure caused by COVID-19 often requires mechanical ventilation, including extracorporeal membrane oxygenation (ECMO). In rare cases, lung transplantation (LTx) may be considered as a last resort. However, uncertainties remain about patient selection and optimal timing for referral and listing. This retrospective study analyzed patients with severe COVID-19 who were supported by veno-venous ECMO and listed for LTx between July 2020 and June 2022. Out of the 20 patients in the study population, four who underwent LTx were excluded. The clinical characteristics of the remaining 16 patients were compared, including nine who recovered and seven who died while awaiting LTx. The median duration from hospitalization to listing was 85.5 days, and the median duration on the waitlist was 25.5 days. Younger age was significantly associated with a higher likelihood of recovery without LTx after a median of 59 days on ECMO, compared to those who died at a median of 99 days. In patients with severe COVID-19-induced lung damage supported by ECMO, referral to LTx should be delayed for 8–10 weeks after ECMO initiation, particularly for younger patients who have a higher probability of spontaneous recovery and may not require LTx.
KW - acute respiratory distress syndrome (ARDS)
KW - coronavirus disease 2019 (COVID-19)
KW - extracorporeal membrane oxygenation (ECMO)
KW - lung transplant
UR - http://www.scopus.com/inward/record.url?scp=85163971152&partnerID=8YFLogxK
U2 - 10.3390/jcm12124041
DO - 10.3390/jcm12124041
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C2 - 37373734
AN - SCOPUS:85163971152
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 12
M1 - 4041
ER -
