Doctors based in Chennai performed a bilateral lung transplant on a Covid19 patient last week, making it the first such procedure to happen in Asia.
The patient, a 45-year-old man, tested positive for Covid19 in June. His condition deteriorated due to Covid19-related fibrosis — a calcification of tissue that makes it difficult for the lungs to work properly. In less than two weeks after his diagnosis, the patient had to receive ventilator support as his oxygen levels dipped. In July, he was airlifted from Ghaziabad to MGM Healthcare hospital in Chennai. The transplant surgery took place on August 27th, and the patient is currently stable and off ECMO support.
The novel coronavirus may belong to the same virus family as the common cold, but the damage it can cause to bodily organs is a lot more severe. Primarily an acute respiratory illness, Covid19 can cause scarring on both lungs, which later puts people (especially the elderly) at risk for pulmonary fibrosis and resultant shortness of breath.
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Lung transplants may be effective in the face of critical fibrosis complications like this case, but they also are heavily invasive, expensive procedures that is dependent upon donor availability. Plus, it is important to note that a lung transplant is not viable for everyone. In order to increase the probability of a successful transplant, medical professionals must make sure their transplant candidate can handle the surgery and the rehabilitation required post the transplant.
According to some of ten guidelines for Covid19 related lung transplants set down by The Lancet, transplant candidates are always younger than 65 years of age, should have single-organ dysfunction only, should have adequate body mass index, and should be awake to discuss and consent to the transplant procedure Most importantly, the transplant candidate should have a recent Covid19 negative result, as infected candidates are a lot more likely to die. The Lancet article also notes that most patients with severe lung failure are likely to have comorbidities that prevent them from being transplant candidates. As the writers note, “Thus, prevention of COVID-19 infection remains the best strategy to save lives.”
