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Management of Lung Transplantation in the COVID-19 Era
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Management of Lung Transplantation in the COVID-19 Era

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (25 April 2023) | Viewed by 2815

Special Issue Editor

Dr. Nadim Cassir

E-Mail Website
Guest Editor
IHU-Méditerranée Infection, Aix Marseille Université, IRD, AP-HM, MEPHI, 13385 Marseille, France
Interests: transplanted infectious diseases; infection in intensive care unit patients; infection control in immunosuppressed patients

Special Issue Information

Dear Colleagues,

As the coronavirus disease 2019 (COVID-19) pandemic continues, lung transplantation faces critical challenges. First, there were concerns that immunosuppression would predispose solid organ transplant (SOT) recipients to more severe or fatal disease than the general population. These concerns stemmed from experience with other respiratory viruses and from early reports of high mortality in SOT recipients. However, recent matched cohort studies have consistently reported that SOT-related immunosuppressive therapy may not have an independent detrimental effect on COVID-19 outcomes. An optimal management of immunosuppression regimens to mitigate disease severity has not yet been established. Second, the transplantation of the lungs of donors with a history of COVID-19 infection is a critical issue, as donor-derived virus infection and graft dysfunction are possible after transplantation. However, the use of such lungs could save the lives of patients requiring emergency transplantation. Third, lung transplantation has been carried out successfully, with good early post-transplantation outcomes, in carefully selected patients with severe, unresolving COVID-19-associated acute respiratory distress syndrome (ARDS). However, in this difficult condition, the healing potential of lung parenchyma should not be underestimated.

Dr. Nadim Cassir
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • SARS-CoV-2
  • lung transplant recipients
  • solid organ transplantation
  • immunosuppression

Published Papers (2 papers)

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9 pages, 870 KiB  
Brief Report
Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
by Liran Levy, Ofir Deri, Ella Huszti, Eyal Nachum, Stephane Ledot, Nir Shimoni, Milton Saute, Leonid Sternik, Ran Kremer, Yigal Kassif, Nona Zeitlin, Jonathan Frogel, Ilya Lambrikov, Ilia Matskovski, Sumit Chatterji, Lior Seluk, Nadav Furie, Inbal Shafran, Ronen Mass, Amir Onn, Ehud Raanani, Amir Grinberg, Yuval Levy, Arnon Afek, Yitshak Kreiss and Alexander Koganadd Show full author list remove Hide full author list
J. Clin. Med. 2023, 12(12), 4041; https://doi.org/10.3390/jcm12124041 - 14 Jun 2023
Cited by 2 | Viewed by 1056
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Management of Lung Transplantation in the COVID-19 Era)
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5 pages, 1114 KiB  
Case Report
Lung Transplant for ARDS after COVID-19: Long-Term Outcomes and Considerations about Detrimental Issues
by Alessandro Palleschi, Stefania Crotti, Anna Mara Scandroglio, Alfredo Lissoni, Evgeny Fominskiy, Lorenzo Rosso, Davide Tosi, Valeria Musso, Francesco Blasi, Andrea Gori and Mario Nosotti
J. Clin. Med. 2022, 11(16), 4754; https://doi.org/10.3390/jcm11164754 - 15 Aug 2022
Cited by 3 | Viewed by 1344
Abstract
During the first outbreak of COVID-19 in Italy, based on the only few cases reported from a Chinese centre at the time, we performed lung transplantation in two patients with irreversible acute respiratory distress syndrome (ARDS) after COVID-19 at our centre. After two [...] Read more.
During the first outbreak of COVID-19 in Italy, based on the only few cases reported from a Chinese centre at the time, we performed lung transplantation in two patients with irreversible acute respiratory distress syndrome (ARDS) after COVID-19 at our centre. After two years, we report the outcomes of these cases and some considerations. The first patient, an 18-year-old male, is in excellent conditions twenty-four months after surgery. The second patient was a 48-year-old man; his airways were colonized by carbapenemase-producing klebsiella pneumoniae at the time of lung transplantation, and he had previously suffered from delirium and hallucinations in the intensive care unit. His postoperative clinical course was complicated by dysexecutive behaviour and then septic shock; he died 62 days after surgery. The recently reported experience of different transplantation centres has led to the inclusion of irreversible acute respiratory distress syndrome (ARDS) after COVID-19 among the indications for lung transplantation in carefully selected patients. Our results confirm the feasibility and the good long-term outcomes of lung transplantation for COVID-19-associated ARDS. Nonetheless, our experience corroborates the need for careful recipient selection: special attention must be paid to the single-organ dysfunction principle, the evaluation of any neuro-psychiatric disorder, and MDR germs colonization, before listing. Full article
(This article belongs to the Special Issue Management of Lung Transplantation in the COVID-19 Era)
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