Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis

Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-sta...

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Published inChinese medical journal Vol. 133; no. 12; pp. 1390 - 1396
Main Authors Chen, Jing-Yu, Qiao, Kun, Liu, Feng, Wu, Bo, Xu, Xin, Jiao, Guo-Qing, Lu, Rong-Guo, Li, Hui-Xing, Zhao, Jin, Huang, Jian, Yang, Yi, Lu, Xiao-Jie, Li, Jia-Shu, Jiang, Shu-Yun, Wang, Da-Peng, Hu, Chun-Xiao, Wang, Gui-Long, Huang, Dong-Xiao, Jiao, Guo-Hui, Wei, Dong, Ye, Shu-Gao, Huang, Jian-An, Zhou, Li, Zhang, Xiao-Qin, He, Jian-Xing
Format Journal Article
LanguageEnglish
Published China The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license 20.06.2020
Lippincott Williams & Wilkins Ovid Technologies
Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Thoracic Surgery, Shenzhen Third People’s Hospital, Shenzhen, Guangdong 518100, China%Department of Thoracic Surgery/Oncology, State Key Laboratory and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China%Department of Cardiothoracic Surgery, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China%Wuxi Fifth Hospital, Wuxi, Jiangsu 214000, China%Department of Respiratory Medicine and Critical Care Medicine, The First People’s Hospital of Lianyungang City, Lianyungang, Jiangsu 222061, China%Department of Critical Care Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Anesthesiology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
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Abstract Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients. From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores. Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation. LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
AbstractList Background. Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients. Methods. From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores. Results. Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation. Conclusions. LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients. From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores. Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation. LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.BACKGROUNDCritical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.METHODSFrom February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.RESULTSTwo of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.CONCLUSIONSLT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
BackgroundCritical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.MethodsFrom February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.ResultsTwo of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.ConclusionsLT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
Abstract_FL Background::Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.Methods::From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.Results::Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.Conclusions::LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.
Author Huang, Jian-An
Lu, Xiao-Jie
Xu, Xin
Jiang, Shu-Yun
Zhao, Jin
Li, Jia-Shu
Jiao, Guo-Hui
Wang, Da-Peng
Huang, Dong-Xiao
Liu, Feng
Lu, Rong-Guo
Zhang, Xiao-Qin
He, Jian-Xing
Huang, Jian
Zhou, Li
Wu, Bo
Wang, Gui-Long
Jiao, Guo-Qing
Wei, Dong
Qiao, Kun
Ye, Shu-Gao
Chen, Jing-Yu
Hu, Chun-Xiao
Li, Hui-Xing
Yang, Yi
AuthorAffiliation Department of Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
Department of Anesthesiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
Department of Respiratory Medicine and Critical Care Medicine, The First People's Hospital of Lianyungang City, Lianyungang, Jiangsu 222061, China
Department of Cardiothoracic Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
Wuxi Fifth Hospital, Wuxi, Jiangsu 214000, China
Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
Department of Thoracic Surgery/Oncology, State Key Labora
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– name: Department of Respiratory Medicine and Critical Care Medicine, The First People's Hospital of Lianyungang City, Lianyungang, Jiangsu 222061, China
– name: Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
– name: Department of Cardiothoracic Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
– name: Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
– name: Department of Thoracic Surgery, Shenzhen Third People's Hospital, Shenzhen, Guangdong 518100, China
– name: Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
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Author_FL Yang Yi
Hu Chun-Xiao
Jiang Shu-Yun
Wei Dong
Ye Shu-Gao
Wang Gui-Long
Zhang Xiao-Qin
Li Hui-Xing
Wang Da-Peng
Xu Xin
Jiao Guo-Qing
Liu Feng
Huang Dong-Xiao
Li Jia-Shu
Jiao Guo-Hui
Zhao Jin
Huang Jian
Huang Jian-An
Lu Rong-Guo
Wu Bo
Zhou Li
Qiao Kun
Chen Jing-Yu
Lu Xiao-Jie
He Jian-Xing
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  organization: Department of Thoracic Surgery/Oncology, State Key Laboratory and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32251003$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
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Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. 2020
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Issue 12
Keywords Acute respiratory distress syndrome
Pulmonary fibrosis
Coronavirus disease 2019
Sequential Organ Failure Assessment score
Lung transplantation
Language English
License http://creativecommons.org/licenses/by-nc-nd/4.0
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Lippincott Williams & Wilkins Ovid Technologies
Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Thoracic Surgery, Shenzhen Third People’s Hospital, Shenzhen, Guangdong 518100, China%Department of Thoracic Surgery/Oncology, State Key Laboratory and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China%Department of Cardiothoracic Surgery, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China%Wuxi Fifth Hospital, Wuxi, Jiangsu 214000, China%Department of Respiratory Medicine and Critical Care Medicine, The First People’s Hospital of Lianyungang City, Lianyungang, Jiangsu 222061, China%Department of Critical Care Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Anesthesiology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China%Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
Wolters Kluwer Health
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References Salam (R12-20230816) 2017; 63
Huang (R14-20230816) 2020; 395
Huang (R5-20230816) 2017; 6
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Luo (R9-20230816) 2020
Zhou (R7-20230816) 2020; 395
Wu (R13-20230816) 2020; 8
Chang (R11-20230816) 2018; 102
Cucinotta (R2-20230816) 2020; 91
Wang (R4-20230816) 2020
Guan (R3-20230816) 2020
(R8-20230816) 2020
Chen (R6-20230816) 2018; 9
32718694 - J Heart Lung Transplant. 2020 Sep;39(9):983-985
32631838 - Eur Respir J. 2020 Aug 27;56(2)
References_xml – volume: 395
  start-page: 1054
  year: 2020
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– volume: 6
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  year: 2017
  ident: R5-20230816
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  publication-title: Hepatobiliary Surg Nutr
  doi: 10.21037/hbsn.2017.07.08
– volume: 8
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  doi: 10.21037/atm.2019.10.26
– volume: 102
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  ident: R11-20230816
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  publication-title: Transplantation 2018;
– volume: 9
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  publication-title: Organ Transplantation
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Snippet Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal...
BackgroundCritical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving...
Background::Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving...
Background. Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving...
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SubjectTerms Aged
Betacoronavirus
Blood & organ donations
Coronary vessels
Coronavirus Infections - complications
Coronavirus Infections - mortality
Coronaviruses
COVID-19
Disease transmission
Extracorporeal Membrane Oxygenation
Heart
Hospitals
Humans
Lung Transplantation - methods
Lung transplants
Male
Medical personnel
Middle Aged
Original
Pandemics
Patients
Pneumonia, Viral - complications
Pneumonia, Viral - mortality
Pulmonary fibrosis
Pulmonary Fibrosis - mortality
Pulmonary Fibrosis - surgery
Rehabilitation
Respiratory distress syndrome
Respiratory Distress Syndrome - mortality
Respiratory Distress Syndrome - surgery
Respiratory failure
SARS-CoV-2
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Title Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis
URI https://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00029330-202006200-00002
https://www.ncbi.nlm.nih.gov/pubmed/32251003
https://www.proquest.com/docview/2480933474
https://www.proquest.com/docview/2387253747
https://d.wanfangdata.com.cn/periodical/zhcmj202012029
https://pubmed.ncbi.nlm.nih.gov/PMC7339336
https://doaj.org/article/9de52c961f1f4cfa81cf73142ecf9810
Volume 133
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