24 December 2024 : Original article
Lung Transplant Success in COVID-19 Patients Requiring V-V ECMO: One-Year Follow-Up
Mazen F. Odish
ABCDE 1*, Travis Pollema ACDE 2, Christine M. Lin BCEF 1, Robert L. Owens CE 1, Cassia Yi BE 2, Shannon LeBlanc BE 1, Chelsea Roche BE 1, Catherine Gaissert BCE 1, Gordon Yung BCE 1, Aarya Kafi BCE 1, Eugene M. Golts ACE 2, Kamyar Afshar ABCEF 1
DOI: 10.12659/AOT.946088
Ann Transplant 2024; 29:e946088
Table 1 Demographics and characteristics of patients with COVID-19 on V-V ECMO who received and did not receive lung transplantation. Data are n (%), median (IQR), n, or n/n (%) unless stated otherwise.
| Patients with COVID-19 ARDS with lung transplantation | Patients with COVID-19 ARDS without lung transplantation | |
|---|---|---|
| n=9 | n=82 | |
| Sex | ||
| Female | 3 (33%) | 17 (21) |
| Male | 6 (66%) | 65 (79) |
| Age (years) | 48 (36–55) | 47 (38–54) |
| Body mass index (kg/m) | 28.8 (23.1–30.3) | 31.8 (28.7–34.7) |
| Blood group | ||
| A | 2 (22%) | – |
| B | 1 (11%) | – |
| O | 6 (66%) | – |
| AB | 0 (0%) | – |
| Race | ||
| White | 7 (77%) | 67 (81) |
| Black | 0 (0%) | 2 (2) |
| Asian | 2 (22%) | 6 (7) |
| Native Pacific islander | 0 | 2 (2) |
| More than 1 race | 0 | 4 (5) |
| Hispanic ethnicity | 5 (56) | 60 (73) |
| Vaccination status | ||
| Unvaccinated | 8 (89%) | 65 (79) |
| Vaccinated | 1 (11%) | 4 (5) |
| Unknown | 0 | 13 (16) |
| Treatment for COVID-19 | ||
| Corticosteroids | 9 (100%) | 71 (87) |
| Tocilizumab | 2 (22%) | 14 (17) |
| Remdesivir | 5 (56%) | 62 (76) |
| Baricitinib | 2 (22%) | 8 (10) |
| Immunoglobulins | 0 (0%) | 1 (1) |
| SOFA Score at ICU admission | 8.0 (6.0–8.0) | 8 (5.0–9.0) |
| APACHE II Score at ICU admission | 23.0 (15.0–29.0) | – |
| ECLS | ||
| V-V ECMO (single dual-lumen cannula) | 3 (33) | 3 (4) |
| V-V ECMO (2 cannulae) | 6 (66) | 78 (95) |
| Second drainage cannula | 4 (44) | 4 (5) |
| Length of support (days) | 57 (53–78) | 25 (14–44) |
| ECLS Complications | ||
| Air entrapment | 2 (22) | 0 (0) |
| Hemorrhage (>3 units pRBC) | 8 (89) | 24 (29) |
| Venous thromboembolism | 4 (44) | 14 (17) |
| Cerebrovascular accident | 1 (11) | 15 (18) |
| Seizure | 1 (11) | 2 (2) |
| Cardiac arrest | 5 (55) | 8 (10) |
| Limb amputation | 1 (11) | 3 (4) |
| Renal replacement therapy | 1 (11) | 26 (32) |
| Bacterial infection | 8 (89) | – |
| Fungal infection | 3 (33) | – |
| Survival to hospital discharge | 9 (100) | 36 (44) |
| SOFA – sequential related organ failure assessment; APACHE – acute physiology and chronic health evaluation; ECLS – extracorporeal life support; V-V ECMO – veno-venous extracorporeal membrane oxygenation; pRBC – packed red blood cells. | ||