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

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 reports 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and lung transplantation should be considered as a treatment of last chance when extracorporeal life support cannot be withdrawn.Further research is still required to assess the impact of new coronavirus on graft function in lung transplant recipients.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.

Complications associated with bridging to lung transplantation – systematic review and meta-analysis

“…Veno-venous ECMO (VV ECMO) supports respiratory function only while veno-arterial EMCO (VA ECMO) cannulation supports both cardiac and lung function. It can be used as a rescue therapy, for instance, in severe COVID-19 [18]. Another use of this device is to bridge patients to lung transplantation.…”