Surgeons led by Indian-origin doctor perform double lung transplant on second COVID-19 patient

Surgeons led by an Indian-origin doctor have performed a double-lung transplant on a second patient whose lungs were damaged by COVID-19, within a month after the same team conducted what is believed to have been the first such surgery in the US. The patient, an Illinois man in his 60s, spent 100 days on extracorporeal membrane oxygenation (ECMO), a life support machine that does the work of the heart and lungs. He received the transplant last weekend at Northwestern Memorial Hospital in Chicago, the hospital said in a statement.

“This procedure capped an extremely busy holiday weekend for our transplant team. We worked around the clock, performing multiple transplants on non-COVID patients before accepting new lungs for this COVID-19 survivor,” said Dr Ankit Bharat, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Programme, who performed seven lung transplants in seven days.

“Performing back to back lung transplants on such complex patients is demanding work and I’m extremely proud of our team’s dedication. It’s a testament to the infrastructure and expertise of Northwestern Medicine’s Lung Transplant Programme,” the Meerut-born doctor said.

The patient contracted COVID-19 in late March and received the majority of his treatment at another health system before being transferred to Northwestern Memorial Hospital for consideration of a double-lung transplant. Within 72 hours of being listed, the life-saving procedure was performed on July 4. Before the patient’s name was added to the transplant wait-list, he had to test negative for COVID-19.

“Coincidentally, the transplant happened to be on the 100th day of ECMO support. Being on ECMO and separated from the ventilator allowed the patient to participate in daily bedside rehabilitation which is important for lung transplantation,” said Dr Bharat.

Typically, a double-lung transplant takes 6 to 7 hours, but this surgery took about 10 hours due to lung necrosis and severe inflammation in the chest cavities resulting from COVID-19.

“Prior to his arrival at Northwestern Memorial, the patient developed an invasive infection which required a major chest surgery. This was going to make the double-lung transplant substantially more difficult,” says Samuel Kim, MD, Northwestern Medicine thoracic surgeon, who assisted in the double-lung transplant alongside Dr Bharat.

“His lung damage was among the worst I’ve ever seen. When we opened the chest cavity there was a lot of evidence of infection; everything we touched or dissected started bleeding and one misstep could have led to catastrophic consequences.” Northwestern surgeons led by Dr Bharat in June have performed what is believed to have been the first-known lung transplant on a COVID-19 patient in the US last month -- on a woman in her 20s.

The surgeons performed their first on a woman in her 20s whose lungs showed irreversible damage from the virus. She became the first known COVID-19 patient in the United States to receive a double-lung transplant.

“Our first patient continues to recover at an optimal pace,” says Rade Tomic, MD, a pulmonologist and medical director of the Lung Transplant Programme.

“Our second patient is already off the ventilator and is talking to his family. He’s grateful for the care he received from all the health care providers, including those at his original hospital, who helped him get to this point. We’re optimistic that both patients will make a full recovery and return to their daily lives.”