It is a real medical feat. A woman in her twenties whose lungs had been "irreversibly" destroyed by Covid-19 has received a double lung transplant in Chicago, the hospital that saved the patient announced on Thursday. "His lungs showed no signs of recovery, they had even started to develop terminal fibrosis," said Ankit Bharat, chief of thoracic surgery at Northwestern Hospital in Chicago. This corresponds to irreparable damage to lung tissue.
It is the first transplant of this type in the United States, but not in the world, Chinese doctors having performed a double transplant in March on a woman in her 60s. The patient is a Hispanic woman who was previously in good health, but the coronavirus made her gravely ill, to the point that she had to spend six weeks in the intensive care unit, intubated by an artificial respirator and connected to a machine. called ECMO, which de facto replaces the heart and lungs to oxygenate and circulate blood in the body.
Large holes had appeared in his left lung, paving the way for a bacterial infection. These cavities leave the doctors perplexed, as they are specific to Covid-19. The operation, on June 5, lasted 10 hours and was "very difficult", according to the surgeon, because the lungs had with the disease as stuck to the surrounding structures of the body, and were therefore difficult to remove. Ordinarily, for the dozens of transplants he performs each year, the procedure takes about six hours.
But success shows that this type of transplant is possible and safe, says the doctor. "I very much hope that we will be able to operate on more and more patients who are today trapped on an artificial respirator because their lungs have been permanently destroyed," confirms Ankit Bharat.
Several weeks of recovery
The patient, who prefers to remain anonymous, is conscious today but remains on a ventilator. She was able to see her family by video call, according to the doctor. She will remain intubated until she regains her strength after the physical test she underwent, probably several weeks. The first double lung transplant was performed in 1986 in Toronto by G. Alexander Patterson, with whom Dr. Bharat, originally from India, trained.
It was not until the transplant that the patient tested negative for the coronavirus, and that her organs found sufficient functioning, so that she had a realistic chance of survival. "We often had to react very quickly, day and night, to help her with oxygenation and support her other organs so that she could support the transplant," said Beth Malsin, a physician specializing in critical care at Northwestern.
Such irreversible damage to the lungs is extremely rare for a person of this age. "How does a healthy woman in her twenties get there?" We still have so much to learn about the Covid-19, ”adds almost stunned pulmonologist Rade Tomic.
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The team's hope is that patients infected with the coronavirus and able to return home, but who have suffered a permanent loss of respiratory functions, may also one day benefit from a transplant. In the United States the wait for a lung transplant is three to six months. 85% of candidate lungs are considered to be of poor quality, but according to Dr. Bharat, new techniques could lower the bar so that more people on the waiting list can benefit. "If more patients need a transplant, we will find a solution," he concluded.
