open access

Vol 6, No 2 (2021)
Review article
Published online: 2021-06-30
Get Citation

SARS-CoV-2 and lung transplantation. What do we know?

Kajetan Kiełbowski1, Bartosz Kubisa1
DOI: 10.5603/MRJ.2021.0025
·
Medical Research Journal 2021;6(2):131-139.
Affiliations
  1. Department of Thoracic Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland

open access

Vol 6, No 2 (2021)
REVIEW ARTICLES
Published online: 2021-06-30

Abstract

Introduction: In 2019, new Coronavirus (SARS-CoV-2) has spread around the globe. The virus can replicate
in the cells of the lower respiratory tract, causing pneumonia, oedema and hypoxia. In some patients, the
disease will progress to acute respiratory distress syndrome (ARDS) which is a life-threatening condition.
Lung transplantation (LuTx) might be the only rescue therapy for severe respiratory failure. Additionally,
little is known about the impact of SARS-CoV-2 on lung transplant recipients. The purpose of this systematic
review is to present current knowledge about lung transplantation as a treatment method for ARDS
associated with COVID-19 infection and to summarize information regarding the management of COVID
infection in lung transplant recipients.

Materials and methods: Literature search through different databases was conducted. Only case report and case series were included.

Results: Out of 525 initial results, 16 studies were included in this systematic review. 7 articles presented
patients with LuTx as a treatment option for ARDS and 9 presented management of lung recipients infected
with COVID-19. A total of 37 patients were included in this systematic review.

Discussion: The course of reviewed patients with SARS-CoV-2 infection was similar and lung transplantation
should be considered as a treatment of last chance when extracorporeal life support cannot be withdrawn.
Further research is still required to assess the impact of new coronavirus on graft function in lung transplant
recipients. Currently, the treatment strategy involves immunosuppression modification and supplemental
oxygen therapy. However, some patients do not present clinical symptoms.

Abstract

Introduction: In 2019, new Coronavirus (SARS-CoV-2) has spread around the globe. The virus can replicate
in the cells of the lower respiratory tract, causing pneumonia, oedema and hypoxia. In some patients, the
disease will progress to acute respiratory distress syndrome (ARDS) which is a life-threatening condition.
Lung transplantation (LuTx) might be the only rescue therapy for severe respiratory failure. Additionally,
little is known about the impact of SARS-CoV-2 on lung transplant recipients. The purpose of this systematic
review is to present current knowledge about lung transplantation as a treatment method for ARDS
associated with COVID-19 infection and to summarize information regarding the management of COVID
infection in lung transplant recipients.

Materials and methods: Literature search through different databases was conducted. Only case report and case series were included.

Results: Out of 525 initial results, 16 studies were included in this systematic review. 7 articles presented
patients with LuTx as a treatment option for ARDS and 9 presented management of lung recipients infected
with COVID-19. A total of 37 patients were included in this systematic review.

Discussion: The course of reviewed patients with SARS-CoV-2 infection was similar and lung transplantation
should be considered as a treatment of last chance when extracorporeal life support cannot be withdrawn.
Further research is still required to assess the impact of new coronavirus on graft function in lung transplant
recipients. Currently, the treatment strategy involves immunosuppression modification and supplemental
oxygen therapy. However, some patients do not present clinical symptoms.

Get Citation

Keywords

lung transplantation, coronavirus, COVID-19, ARDS

About this article
Title

SARS-CoV-2 and lung transplantation. What do we know?

Journal

Medical Research Journal

Issue

Vol 6, No 2 (2021)

Article type

Review article

Pages

131-139

Published online

2021-06-30

DOI

10.5603/MRJ.2021.0025

Bibliographic record

Medical Research Journal 2021;6(2):131-139.

Keywords

lung transplantation
coronavirus
COVID-19
ARDS

Authors

Kajetan Kiełbowski
Bartosz Kubisa

References (36)
  1. Czajkowska-Malinowska M, Kania A, Kuca PJ, et al. Treatment of acute respiratory failure in the course of COVID-19. Practical hints from the expert panel of the Assembly of Intensive Care and Rehabilitation of the Polish Respiratory Society. Adv Respir Med. 2020; 88(3): 245–266.
  2. Weill D, Benden C, Corris PA, et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2015; 34(1): 1–15.
  3. Cypel M, Keshavjee S. When to consider lung transplantation for COVID-19. The Lancet Respiratory Medicine. 2020; 8(10): 944–946.
  4. Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7): e1000097.
  5. Han W, Zhu M, Chen J, et al. Lung transplantation for elderly patients with end-stage COVID-19 pneumonia. Ann Surg. 2020; 272(1): e33–e34.
  6. Lang C, Jaksch P, Hoda M, et al. Lung transplantation for COVID-19-associated acute respiratory distress syndrome in a PCR-positive patient. The Lancet Respiratory Medicine. 2020; 8(10): 1057–1060.
  7. Chen JY, Qiao K, Liu F, et al. Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis. Chin Med J (Engl). 2020; 133(12): 1390–1396.
  8. Bharat A, Querrey M, Markov NS, et al. Lung transplantation for patients with severe COVID-19. Sci Transl Med. 2020; 12(574).
  9. Chen Y, Wang H, Mou Y, et al. Peri-operative echocardiography for lung transplantation in a critical patient with COVID-19. Cardiovasc J Afr. 2021 [Epub ahead of print]; 32: 1–3.
  10. Hu C, Wang G, Zhou D, et al. The anesthetic management of the first lung transplant for a patient with COVID-19 respiratory failure. J Cardiothorac Vasc Anesth. 2021; 35(3): 917–920.
  11. Croci GA, Vaira V, Trabattoni D, et al. Emergency lung transplantation after COVID-19: immunopathological insights on two affected patients. Cells. 2021; 10(3).
  12. Aigner C, Dittmer U, Kamler M, et al. COVID-19 in a lung transplant recipient. J Heart Lung Transplant. 2020; 39(6): 610–611.
  13. Koczulla RA, Sczepanski B, Koteczki A, et al. SARS-CoV-2 infection in two patients following recent lung transplantation. Am J Transplant. 2020; 20(10): 2928–2932.
  14. Morlacchi LC, Rossetti V, Gigli L, et al. COVID-19 in lung transplant recipients: A case series from Milan, Italy. Transpl Infect Dis. 2020; 22(6): e13356.
  15. Athanazio RA, Costa AN, Carraro RM, et al. Early COVID-19 infection after lung transplantation in a patient with cystic fibrosis. Clinics (Sao Paulo). 2020; 75: e2274.
  16. Cozzi E, Faccioli E, Marinello S, et al. COVID-19 pneumonia in lung transplant recipients: Report of 2 cases. Am J Transplant. 2020; 20(10): 2933–2937.
  17. Raëth J, Tomio A, Eugene A, et al. Immunosuppression in a lung transplant recipient with COVID-19? Lessons from an early case. Respir Med Res. 2020; 78: 100782.
  18. Renaud-Picard B, Gallais F, Ohana M, et al. Bilateral acute cardioembolic limb ischemia after Coronavirus disease 2019 pneumonia in a lung transplant recipient: A case report. Transplant Proc. 2020; 52(9): 2715–2718.
  19. Verleden GM, Godinas L, Lorent N, et al. COVID-19 in lung transplant patients: A case series. Am J Transplant. 2020; 20(11): 3234–3238.
  20. Desmazes-Dufeu N, Coltey B, Amari L, et al. Discordant courses of COVID-19 in a cohabiting couple of lung transplant recipients. Transpl Infect Dis. 2021; 23(1): e13410.
  21. Tay MZ, Poh CM, Rénia L, et al. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20(6): 363–374.
  22. Batah SS, Fabro AT. Pulmonary pathology of ARDS in COVID-19: A pathological review for clinicians. Respir Med. 2021; 176: 106239.
  23. Lechowicz K, Drożdżal S, Machaj F, et al. COVID-19: the potential treatment of pulmonary fibrosis associated with SARS-CoV-2 infection. J Clin Med. 2020; 9(6).
  24. Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020; 213(2): 54–56.e1.
  25. Kowalewski M, Fina D, Słomka A, et al. COVID-19 and ECMO: the interplay between coagulation and inflammation-a narrative review. Crit Care. 2020; 24(1): 205.
  26. Sulica R, Cefali F, Motschwiller C, et al. COVID-19 in pulmonary artery hypertension (PAH) patients: observations from a large PAH center in New York City. Diagnostics (Basel). 2021; 11(1).
  27. Chen J, Qi T, Liu Li, et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect. 2020; 80(5): e1–e6.
  28. Brusasco C, Corradi F, Di Domenico A, et al. Galliera CPAP-Covid-19 study group, collaborators of the Galliera CPAP-COVID-19 study group are. Continuous positive airway pressure in COVID-19 patients with moderate-to-severe respiratory failure. Eur Respir J. 2021; 57(2).
  29. Zheng Y, Wang L, Ben S. Meta-analysis of chest CT features of patients with COVID-19 pneumonia. J Med Virol. 2021; 93(1): 241–249.
  30. Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020; 215(1): 87–93.
  31. Pereira MR, Mohan S, Cohen DJ, et al. COVID-19 in solid organ transplant recipients: Initial report from the US epicenter. Am J Transplant. 2020; 20(7): 1800–1808.
  32. Miesbach W, Makris M. COVID-19: coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clin Appl Thromb Hemost. 2020; 26: 1076029620938149.
  33. Coll E, Fernández-Ruiz M, Sánchez-Álvarez JE, et al. Spanish Group for the Study of COVID-19 in Transplant Recipients. COVID-19 in transplant recipients: The Spanish experience. Am J Transplant. 2021; 21(5): 1825–1837.
  34. Messika J, Eloy P, Roux A, et al. French Group of Lung Transplantation. COVID-19 in lung transplant recipients. Transplantation. 2021; 105(1): 177–186.
  35. Picard C, Le Pavec J, Tissot A, et al. Groupe Transplantation Pulmonaire de la Société de Pneumologie de Langue Française SPLF, Groupe Transplantation Pulmonaire de la Société de Pneumologie de Langue Française SPLF. Impact of the Covid-19 pandemic and lung transplantation program in France. Respir Med Res. 2020; 78: 100758.
  36. Hardman G, Sutcliffe R, Hogg R, et al. NHS Blood, Transplant Cardiothoracic Advisory Group Clinical Audit Group. The impact of the SARS-CoV-2 pandemic and COVID-19 on lung transplantation in the UK: Lessons learned from the first wave. Clin Transplant. 2021; 35(3): e14210.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.