Garza-Castillon Rafael, Bharat Ankit
Division of Thoracic Surgery.
Division of Pulmonary & Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Curr Opin Anaesthesiol. 2023 Feb 1;36(1):11-19. doi: 10.1097/ACO.0000000000001203. Epub 2022 Oct 27.
The purpose of this review is to analyze the most recent and relevant literature involving lung transplantation for coronavirus disease 2019 (COVID-19) associated acute respiratory distress syndrome (ARDS), the pathological mechanisms of lung injury, selection criteria and outcomes.
Pathological analysis of lungs after COVID-19 ARDS has shown architectural distortion similar to that observed in explanted lungs from patients undergoing lung transplantation for end-stage lung diseases such as emphysema. Short-term outcomes after lung transplantation for COVID-19 associated respiratory failure are comparable to those performed for other indications.
Lung transplantation after COVID-19 ARDS is a potentially life-saving procedure for appropriately selected patients with no evidence of lung function recovery despite maximal treatment. Lung transplantation should be ideally performed in high-volume centers with expertise.
本综述旨在分析涉及2019冠状病毒病(COVID-19)相关急性呼吸窘迫综合征(ARDS)肺移植的最新及相关文献、肺损伤的病理机制、选择标准和预后。
COVID-19 ARDS后肺的病理分析显示结构扭曲,类似于因肺气肿等终末期肺病接受肺移植患者的离体肺所观察到的情况。COVID-19相关呼吸衰竭肺移植后的短期预后与其他适应证的肺移植相当。
对于经最大程度治疗仍无肺功能恢复证据的适当选择的患者,COVID-19 ARDS后肺移植是一种可能挽救生命的手术。肺移植理想情况下应在具备专业知识的大容量中心进行。