A critically ill COVID-19 patient just got a double lung transplant

It’s reportedly the first time a coronavirus patient has had this surgery in the United States

ECMO room at Northwestern Memorial Hospital

The young woman who received the double lung transplant hospital was so severely ill that she required extracorporeal membrane oxygenation, or ECMO. This life support machine bypasses the heart and lung to provide enough blood flow and oxygen to other organs. That care would have occurred in an ECMO room like the one shown here at Northwestern Memorial Hospital.

Northwestern Medicine

The successful transplantation of a donor’s lungs to a severely ill COVID-19 patient may offer others with irreversibly damaged lungs a means of survival.

A young woman whose lungs were inflamed and scarred beyond repair because of COVID-19 has received a double lung transplant, doctors at Northwestern Memorial Hospital in Chicago said in a news briefing June 11. It’s believed to be the first time this procedure has been used for a coronavirus patient in the United States. Similar transplants have been reported in Austria and China.

“If she didn’t get the transplant, she would not be alive,” said Ankit Bharat, a thoracic surgeon at Northwestern Feinberg School of Medicine who headed the transplant team. It’s not clear yet how many patients whose lungs are destroyed by the coronavirus could benefit from this approach, he said.

The Northwestern patient, a Hispanic woman in her 20s, had no health problems before her infection. Almost as soon as she had arrived at the hospital she needed help breathing with a mechanical ventilator, a sign of “how sick her lungs already were,” said Elizabeth Malsin, a pulmonary and critical care specialist at Northwestern Memorial Hospital.

A COVID-19 infection can cause pneumonia, leaving alveoli — the little air sacs that allow the lungs and the blood to swap oxygen and carbon dioxide — inflamed and filled with fluid. While some people recover from the pneumonia, others may experience long-lasting lung damage (SN: 4/27/20). The young woman was in the intensive care unit for about six weeks. But once she’d finally cleared the virus, the damage unleashed by the virus had obliterated the alveoli.

“Once the lungs get permanently damaged they just don’t get better,” Bharat says.  “We don’t have enough medications to get them back.” The June 5 double lung transplant took about 10 hours — a few hours longer than is usual — because the dense scarring in the patient’s lungs left them stuck to surrounding structures, Bharat said. But she is improving every day, he said, and has been able to FaceTime with her family. “Yesterday she smiled and told me … ‘Doc, thank you for not giving up on me.’”

COVID-19 lung
This section of a lung from a COVID-19 patient who received a double lung transplant shows damage and scarring beyond recovery. A healthy lung looks like a sponge, with lots of air pockets.Northwestern Medicine

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