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Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience

PURPOSE: The emergence of the COVID-19 pandemic is unprecedented and poses a challenge in the history of organ transplantation. 2 main decision making challenges related to Transplantation are : starting immunosuppression which potentially can lead to unfavourable outcomes if recipients develop COVI...

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Autores principales: Shah, U., Rahulan, V., Kumar, P., Dutta, P., Attawar, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979388/
http://dx.doi.org/10.1016/j.healun.2021.01.892
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author Shah, U.
Rahulan, V.
Kumar, P.
Dutta, P.
Attawar, S.
author_facet Shah, U.
Rahulan, V.
Kumar, P.
Dutta, P.
Attawar, S.
author_sort Shah, U.
collection PubMed
description PURPOSE: The emergence of the COVID-19 pandemic is unprecedented and poses a challenge in the history of organ transplantation. 2 main decision making challenges related to Transplantation are : starting immunosuppression which potentially can lead to unfavourable outcomes if recipients develop COVID-19 versus deferring transplantation and accepting associated waitlist mortality. Post COVID fibrotic end stage lung disease phenotype on ECMO support as a bridge to LTx (Lung Transplantation) is an emerging indication worldwide but with challenges. We report an impact of COVID pandemic on Lung Transplantation program ,an Indian experience METHODS: We did a retrospective study from 1(st) March 2017 till 15 (th) October 2020. Demographics, Pre-Existing Lung Diseases, Methods of diagnosing SARS-CoV infection, Transplant status and Treatment for SARS-CoV infection were all taken into consideration RESULTS: 140 patients have undergone LTx since the time period mentioned. Out of 140 post LTx patients, 2 recipients ( 1.4%) developed SARS-CoV infection out of which 1 patient expired. Out of 24 patients on waitlist from March 2020 to October 2020, 7 patients (29%) developed SARS-CoV Infection. Out of these 7 patients on waitlist, 3 patients (42%) recovered and underwent BLTx (Bilateral) successfully , 3 patients expired (42%) and 1 patient is awaiting LTx. Among these 7 patients awaiting LTx, pre-operatively, 1 had severe PAH (14%), 1 had End Stage Sarcoidosis (14%), 2 had post COVID fibrotic end stage lung disease on ECMO support (28%) and 3 patients had RA-ILD (42%). Among 3 patients while awaiting LTx who expired, 2 patients had underlying post COVID fibrotic end stage lung disease on ECMO support and 1 patient had RA-ILD (Rheumatoid). CONCLUSION: Post Lung Transplantation , few recipients seems to be developing SARS-CoV infection although we require larger retrospective studies for the same. Post COVID fibrotic end stage lung disease phenotype on ECMO support as a bridge to LTx may have significant waitlist mortality and candidacy for LTx should be judiciously determined.
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spelling pubmed-79793882021-03-23 Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience Shah, U. Rahulan, V. Kumar, P. Dutta, P. Attawar, S. J Heart Lung Transplant (777) PURPOSE: The emergence of the COVID-19 pandemic is unprecedented and poses a challenge in the history of organ transplantation. 2 main decision making challenges related to Transplantation are : starting immunosuppression which potentially can lead to unfavourable outcomes if recipients develop COVID-19 versus deferring transplantation and accepting associated waitlist mortality. Post COVID fibrotic end stage lung disease phenotype on ECMO support as a bridge to LTx (Lung Transplantation) is an emerging indication worldwide but with challenges. We report an impact of COVID pandemic on Lung Transplantation program ,an Indian experience METHODS: We did a retrospective study from 1(st) March 2017 till 15 (th) October 2020. Demographics, Pre-Existing Lung Diseases, Methods of diagnosing SARS-CoV infection, Transplant status and Treatment for SARS-CoV infection were all taken into consideration RESULTS: 140 patients have undergone LTx since the time period mentioned. Out of 140 post LTx patients, 2 recipients ( 1.4%) developed SARS-CoV infection out of which 1 patient expired. Out of 24 patients on waitlist from March 2020 to October 2020, 7 patients (29%) developed SARS-CoV Infection. Out of these 7 patients on waitlist, 3 patients (42%) recovered and underwent BLTx (Bilateral) successfully , 3 patients expired (42%) and 1 patient is awaiting LTx. Among these 7 patients awaiting LTx, pre-operatively, 1 had severe PAH (14%), 1 had End Stage Sarcoidosis (14%), 2 had post COVID fibrotic end stage lung disease on ECMO support (28%) and 3 patients had RA-ILD (42%). Among 3 patients while awaiting LTx who expired, 2 patients had underlying post COVID fibrotic end stage lung disease on ECMO support and 1 patient had RA-ILD (Rheumatoid). CONCLUSION: Post Lung Transplantation , few recipients seems to be developing SARS-CoV infection although we require larger retrospective studies for the same. Post COVID fibrotic end stage lung disease phenotype on ECMO support as a bridge to LTx may have significant waitlist mortality and candidacy for LTx should be judiciously determined. Published by Elsevier Inc. 2021-04 2021-03-20 /pmc/articles/PMC7979388/ http://dx.doi.org/10.1016/j.healun.2021.01.892 Text en Copyright © 2021 Published by Elsevier Inc. 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 (777)
Shah, U.
Rahulan, V.
Kumar, P.
Dutta, P.
Attawar, S.
Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title_full Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title_fullStr Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title_full_unstemmed Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title_short Impact of COVID Pandemic on Lung Transplantation Program: An Indian Experience
title_sort impact of covid pandemic on lung transplantation program: an indian experience
topic (777)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979388/
http://dx.doi.org/10.1016/j.healun.2021.01.892
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