Background: Coronavirus disease 2019 (COVID-19) has caused 754,948 cases involving 203 countries, as of April 1st, 2020. Emerging infectious diseases threatened to organ donation and transplantation, thus reduced the case volume during the outbreak of COVID-2019. Transplant clinicians have been struggled to balance the risk from donors and survival demand of the transplant candidates. We hereby review our cohort data and report our preliminary experience with lung transplantation (LT) patients during the outbreak of COVID-19.
Methods: We retrospectively analyzed the nationwide data of China Lung Transplantation Registration from January 23rd 2020 to March 23rd 2020, comparing to the same period of that in 2019. General characteristics, pre-LT and post-LT variables were collected and compared.
Results: From January 23rd, 2020 to March 23rd, 2020, there were twenty-eight LT cases performed in total, including five cases of LT for acute respiratory distress syndrome (ARDS) patients due to post-COVID-19 related pulmonary fibrosis. Comparing to those transplanted within the same period of 2019, we transplanted more severe patients with shortened pre-LT admission time and early mobilization post-LT. Strict principles and stratification system were implemented to screen donors, recipients, close contact care providers and related medical staffs. Screening tools included contract tracing, nucleic acid and antibody tests and chest imaging. All the donations and transplantations were successfully performed without infection of medical staffs. There is no donor-related infection caused in the survival recipients. With the strict workflow and measures, early transplant outcomes were not compromised even with the COVID-19 outbreak. Further, a synopsis model of lung donation and transplantation in the midst pandemic has been established. Suggestions of appropriate measures to be taken for the management of immunocompromised patients further provided.
Conclusion: Our preliminary data demonstrated the feasibly and safety of lung donation and transplantation with scrutinized consideration of COVID-19 epidemic trend. Fledging efforts were offered to prepare the transplant teams with management practices, thus safeguarding the vulnerable group of donors, the health of recipients and all the medical staffs involved.