Lung transplants became life-saving surgeries for patients whose lungs were irreversibly damaged from Covid-19.  As you might suspect, lung transplants are a radical, surgical answer to lung disease.

However, we now have updated data on the significant help this surgery gave US Covid patients for the last two years.  The doctors and scientists of the prestigious Cedars Sinai have revealed an updated study exclusively about Covid patients who benefited from lung transplantations.  You’ll notice the ECMO machine also contributed to saving lives.

 

Lung Transplants and Life after Covid Damage

Lung transplants Succeed With ECMO. With

Life-Giving Lung Replacements Yield New Data and Teach Doctors Lessons in Surviving COVID 19 and ECMO Usage.

Likewise, a Smidt Heart Institute analysis of lung transplantation “shows significant help for patients with severe, irreversible lung damage from COVID-19.”

  • The research study featured more than 3,000 lung transplants in the U.S. between Aug. 1, 2020, and Sept. 30, 2021.
  • Briefly, it demonstrated positive results during the worst of the pandemic.  Furthermore, surgeons performed seven percent of the US lung transplants due to hopeless damage inflicted by the Covid virus.
  • Additionally, we know that over half of these patients required ventilators or ECMO machines.

 

Update on the Lung Transplant Hero:  ECMO

We have sung the praises of the ECMO in previous blogs.  Its name comes from its function: “extracorporeal membrane oxygenation.” ECMO keeps a patient alive before and sometimes after a lung transplant procedure.

Joanna Chikwe, MD, is the founding chair of the Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai. Additionally, she is the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery.

She  stated unequivocally, “Our experience treating COVID-19 has shown us that ECMO can be used in carefully selected patients…”  She then declared two ways ECMO has been a hero machine during Covid.

  1. ECMO can provide “a bridge to lung transplantation.“
  2. Likewise, she explained that ECMO could be used to allow a patient’s own lungs to heal…”

More about ECMO and Covid-19 Patients

Dr. Chikwe was also the corresponding author of the special lung transplant data published in The New England Journal of Medicine (NEJM).  She puts dry statistics into human terms.

“Most of these COVID-19 patients would have been considered too ill to transplant a few years ago…”  Then she added, “and the surprising finding of our research was how well they did after lung transplantation.”

 

ECMO and the Lung Transplant:  Heroes in the Time of the Pandemic

Previously, the ECMO machine was reserved for last resort patients. However, doctors have always used it for lung transplants.  Currently, in some hospitals, it has been used to save the lives of lung transplant patients who lost their original lungs due to Covid-19 damage.

To put it briefly, ECMO supports the failing respiratory system. And, in some cases, it helps patients gain strength as they await lungs for a transplant. Patients helped by ECMO tolerate their surgery lung transplants better.

 

A Quick Review of the Functions of ECMO

The ECMO Machine is Similar to a Heart-Lung Machine. It Functions For Your Lungs While You await Your Lung Surgery.

We have previously blogged about ECMO and the way it cycles blood.  However, we think it is time to review its almost magical abilities.

While on ECMO, a patient’s blood is pumped out of their body.  It is then put through an artificial lung and then, pumped back into the patient’s body.

The machine is similar to a heart-lung bypass machine. It has been available for decades.  But its use for lung failure has increased significantly in the past decade… And especially in the last two years.

With ECMO, once a patient’s blood is in the machine, it passes along a membrane (referred to as an “oxygenator” or “gas exchanger.”)

  • This process provides an interface between the blood and freshly delivered oxygen.
  • This action is exactly what your lungs do for you, every breath of every day.
  • The ECMO system might warm or cool blood as needed.
  • Then it returns the blood either to a central vein (“venovenous ECMO”) or to an artery (“venoarterial ECMO”).

 

The Gift of the ECMO Machine:  Time to Heal

In the time of the pandemic, the ECMO has helped transplant cases… Additionally, it has also rescued strong patients who just needed time to heal their lungs. Now, the Cedars-Sinai physicians have utilized the ECMO technology so often that they “have learned new, effective ways to utilize the machine and save lives.”

 

Outstanding Statistics from Lung Transplants During the Pandemic

Lung Transplants With the ECMO Provides New Hope for Lung Damage.

Gift of Life From Lung Transplant Patients, Doctors, and ECMO.

Researchers have tabulated results from 3,039 lung transplantations in the US in the previous 2 years. Thus, inquiring minds might like to know some of these numbers:

1.  The average age of COVID-19 lung transplant patients was 52.

2.  21% of COVID-19 lung transplant patients were female.

3.  36.6% of COVID-19 lung transplant patients were Hispanic.

4.  Among 214 COVID-19 lung transplants, the “survival rate was 95.6%.”

Perhaps the most outstanding statistic was that of the 214 COVID-19 surviving lung transplants. 140 patients had COVID-19 acute respiratory distress syndrome. The other 74 patients were suffering from COVID-19 pulmonary fibrosis. For those unfamiliar with the term, Dr. Roach offered the following explanation.

Amy Roach, MD. is a general surgery resident and Nagel Research Fellow in the Department of Cardiac Surgery (Smidt Heart Institute).  She explained this term thusly.

“Acute respiratory distress syndrome involves an acute inflammation of the lungs…”  And she added, this results “in a decreased ability for the lungs to oxygenate and ventilate.” She concluded, “In some patients, this progresses to COVID-19 pulmonary fibrosis, which causes scarring in the lung and is generally irreversible.”

 

How To Treat Patients with ECMO and Lung Transplants

Dr. Dominick Megna is the surgical director of the Lung Transplant Program and assistant professor of Cardiac Surgery.  He stated a couple of important factors of patient care.

  1.  “Now we know we must mobilize patients and reduce sedatives, whenever possible.”
  2.  “We also have a deeper understanding of how long an individual patient can safely remain on ECMO.”

Credible ECMO and Lung Transplant Experience

It’s amazing to note that “Between July 2020 and June 30, 2021, Cedars-Sinai provided more than 30,000 hours of ECMO care to patients.”  When we dive deeper into the facts, we realize “Of those 30,000 hours, 21,000 hours were for patients with severe lung disease due to COVID-19.

 

Terrific Take-Aways from Lung Transplants and ECMO

The Vaccine: Even More Powerful than the ECMO Machine or Lung Transplants.

Reinaldo Rampolla, MD, medical director of the Lung Transplant Program at Cedars-Sinai provided us with the two most important Take-Aways from this study.

1. In the first place he said, “Our analysis suggests lung transplants may be a safe option for select patients with the most severe, irreversible lung damage from COVID-19.”

2. Secondly, and perhaps most importantly, he stated, “However, our hope is that no one has to go through ECMO or lung transplant because of COVID-19.”  He explained quickly, “The best protection we have against severe, aggressive disease is vaccination.”