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Uptake and 1-year outcomes of lung transplantation for COVID-19
OBJECTIVE: End-stage lung disease from severe COVID-19 infection is an increasingly common indication for lung transplantation (LT), but there are limited data on outcomes. We evaluated 1-year COVID-19 LT outcomes. METHODS: We identified all adult US LT recipients January 2020 to October 2022 in the...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
by The American Association for Thoracic Surgery
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240904/ https://www.ncbi.nlm.nih.gov/pubmed/37286074 http://dx.doi.org/10.1016/j.jtcvs.2023.05.029 |
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author | Ruck, Jessica M. Zhou, Alice L. Florissi, Isabella Ha, Jinny S. Shah, Pali D. Massie, Allan B. Segev, Dorry L. Merlo, Christian A. Bush, Errol L. |
author_facet | Ruck, Jessica M. Zhou, Alice L. Florissi, Isabella Ha, Jinny S. Shah, Pali D. Massie, Allan B. Segev, Dorry L. Merlo, Christian A. Bush, Errol L. |
author_sort | Ruck, Jessica M. |
collection | PubMed |
description | OBJECTIVE: End-stage lung disease from severe COVID-19 infection is an increasingly common indication for lung transplantation (LT), but there are limited data on outcomes. We evaluated 1-year COVID-19 LT outcomes. METHODS: We identified all adult US LT recipients January 2020 to October 2022 in the Scientific Registry for Transplant Recipients, using diagnosis codes to identify recipients transplanted for COVID-19. We used multivariable regression to compare in-hospital acute rejection, prolonged ventilator support, tracheostomy, dialysis, and 1-year mortality between COVID-19 and non-COVID-19 recipients, adjusting for donor, recipient, and transplant characteristics. RESULTS: LT for COVID-19 increased from 0.8% to 10.7% of total LT volume during 2020 to 2021. The number of centers performing LT for COVID-19 increased from 12 to 50. Recipients transplanted for COVID-19 were younger; were more likely to be male and Hispanic; were more likely to be on a ventilator, extracorporeal membrane oxygenation support, and dialysis pre-LT; were more likely to receive bilateral LT; and had higher lung allocation score and shorter waitlist time than other recipients (all P values < .001). COVID-19 LT had higher risk of prolonged ventilator support (adjusted odds ratio, 2.28; P < .001), tracheostomy (adjusted odds ratio 5.3; P < .001), and longer length of stay (median, 27 vs 19 days; P < .001). Risk of in-hospital acute rejection (adjusted odds ratio, 0.99; P = .95) and 1-year mortality (adjusted hazard ratio, 0.73; P = .12) were similar for COVID-19 LTs and LTs for other indications, even accounting for center-level differences. CONCLUSIONS: COVID-19 LT is associated with higher risk of immediate postoperative complications but similar risk of 1-year mortality despite more severe pre-LT illness. These encouraging results support the ongoing use of LT for COVID-19–related lung disease. |
format | Online Article Text |
id | pubmed-10240904 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | by The American Association for Thoracic Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-102409042023-06-05 Uptake and 1-year outcomes of lung transplantation for COVID-19 Ruck, Jessica M. Zhou, Alice L. Florissi, Isabella Ha, Jinny S. Shah, Pali D. Massie, Allan B. Segev, Dorry L. Merlo, Christian A. Bush, Errol L. J Thorac Cardiovasc Surg Transplantation OBJECTIVE: End-stage lung disease from severe COVID-19 infection is an increasingly common indication for lung transplantation (LT), but there are limited data on outcomes. We evaluated 1-year COVID-19 LT outcomes. METHODS: We identified all adult US LT recipients January 2020 to October 2022 in the Scientific Registry for Transplant Recipients, using diagnosis codes to identify recipients transplanted for COVID-19. We used multivariable regression to compare in-hospital acute rejection, prolonged ventilator support, tracheostomy, dialysis, and 1-year mortality between COVID-19 and non-COVID-19 recipients, adjusting for donor, recipient, and transplant characteristics. RESULTS: LT for COVID-19 increased from 0.8% to 10.7% of total LT volume during 2020 to 2021. The number of centers performing LT for COVID-19 increased from 12 to 50. Recipients transplanted for COVID-19 were younger; were more likely to be male and Hispanic; were more likely to be on a ventilator, extracorporeal membrane oxygenation support, and dialysis pre-LT; were more likely to receive bilateral LT; and had higher lung allocation score and shorter waitlist time than other recipients (all P values < .001). COVID-19 LT had higher risk of prolonged ventilator support (adjusted odds ratio, 2.28; P < .001), tracheostomy (adjusted odds ratio 5.3; P < .001), and longer length of stay (median, 27 vs 19 days; P < .001). Risk of in-hospital acute rejection (adjusted odds ratio, 0.99; P = .95) and 1-year mortality (adjusted hazard ratio, 0.73; P = .12) were similar for COVID-19 LTs and LTs for other indications, even accounting for center-level differences. CONCLUSIONS: COVID-19 LT is associated with higher risk of immediate postoperative complications but similar risk of 1-year mortality despite more severe pre-LT illness. These encouraging results support the ongoing use of LT for COVID-19–related lung disease. by The American Association for Thoracic Surgery 2023-06-05 /pmc/articles/PMC10240904/ /pubmed/37286074 http://dx.doi.org/10.1016/j.jtcvs.2023.05.029 Text en © 2023 by The American Association for Thoracic Surgery. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Transplantation Ruck, Jessica M. Zhou, Alice L. Florissi, Isabella Ha, Jinny S. Shah, Pali D. Massie, Allan B. Segev, Dorry L. Merlo, Christian A. Bush, Errol L. Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title | Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title_full | Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title_fullStr | Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title_full_unstemmed | Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title_short | Uptake and 1-year outcomes of lung transplantation for COVID-19 |
title_sort | uptake and 1-year outcomes of lung transplantation for covid-19 |
topic | Transplantation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240904/ https://www.ncbi.nlm.nih.gov/pubmed/37286074 http://dx.doi.org/10.1016/j.jtcvs.2023.05.029 |
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