Practical experiences of managing COVID-19 in lung transplantation / 中华器官移植杂志

ABSTRACT

Objective:To explore the indications of lung transplantation for pulmonary interstitial fibrosis after COVID-19 and the precautionary measures of medical staff during operation.Methods:Lung transplantation was performed for three cases of COVID-19 from February 15, 2020 to March 1, 2020. The course of disease, mechanical ventilation time, extra-corporeal membrane oxygenation (ECMO) support time, surgical procedures and precautionary measures of medical staff during operation were analyzed.Results:The course of disease were 40, 7, 39 days, the mechanical ventilation time 26, 22, 27 days and ECMO support time 16, 7, 14 days. The postoperative pathological results of three cases indicated pulmonary interstitial fibrosis. One case died on the operative day and two survivors stayed currently in rehabilitation. Thirty-nine medical staff had no symptoms of COVID-19 after 14 days of isolation. The detection of 2019-nCoV nucleic acid was negative for both nasal and pharyngeal swabs.Conclusions:Patients with pulmonary interstitial fibrosis after COVID-19 show no improvement after 1 month of active medical treatment. And the 1-month risk of mortality was over 50% and nucleic acid of 2019-nCoV turned negative. Lung transplantation might be considered. The triple precautionary levels of medical staff during operation prevented the transmission of 2019-nCoV.