Donor Lung Evaluation and Lung Transplantation in the COVID-19 Era.

OBJECTIVES

The COVID-19 pandemic, which emerged in late 2019, adversely affected all solid-organ transplant processes. Here we share the donor presentations evaluated in a lung transplant center during the COVID-19 pandemic,the measures taken at every stage of transplant management, and the outcomes of our transplants.

MATERIALS AND METHODS

Data from 15 lung donors selected by the national coordination center presented to our lung transplant center as of March 11, 2020, when the first COVID-19 case was reported in Turkey, and data of 5 lung transplant cases in this period were retrospectively analyzed. All donors were examined in detail for COVID-19 disease. Procurement processes for accepted donors,transplant surgeries of recipients, and postoperative follow-up and care processes of recipients were carried out with the least number of personnel, but all with appropriate personal protective equipment.

RESULTS

There were 15 donor organs procured by our center during a 9-month period coincident with the COVID-19 pandemic. The number of donor presentations to our center between the same dates in the previous year was 78. Five of the 15 donors were accepted, and of those accepted, 4 were male and 1 was female. There was no statistically significant difference between the accepted and rejected donors in terms of the ratio of Pao2 to fraction of inspired oxygen, age, duration of endotracheal intubation (days), and smoking (pack-years). All SARS-CoV-2 reverse transcription-polymerase chain reaction tests performed on bronchoalveolar lavage samples and nasopharyngeal, conjunctival, and rectal samples collected from the recipients during the follow-up period were negative. No pathological finding suggestive of COVID-19 infection was noted in the radiological evaluations.

CONCLUSIONS

Lung transplant can be successfully managed during the COVID-19 pandemic period, despite the high risk of infection.The major obstacle to the continuity of lung transplantin this period was the limited number of donors.