Northwestern Medicine

Northwestern Medicine Performs Double-Lung Transplant on a Second COVID-19 Patient

Northwestern Memorial Hospital July 09, 2020

Northwestern Medicine surgeons have performed a double-lung transplant on a second patient whose lungs were damaged by COVID-19. 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. 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 over the Fourth of July weekend.

“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,” explains Ankit Bharat, MD, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program, 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 Program.”

Before the patient’s name was added to the transplant wait-list, he had to test negative for COVID-19. Due to the extended support with ECMO, his body could clear the virus, providing the consideration of transplantation.

“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,” explains 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.”

This marked the second time a double-lung transplant has been performed on a patient affected by COVID-19 at Northwestern Memorial. In June, 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 optimal pace,” says Rade Tomic, MD, a pulmonologist and medical director of the Lung Transplant Program. “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.”

“Since performing our first double-lung transplant on a COVID-19 patient, our team has been speaking with other transplant centers around the world, offering guidance and assuring them that this can be done safely,” adds Dr. Bharat. “We’re planning to add more patients to the wait-list at Northwestern Medicine in the coming weeks. While lung transplantation isn’t for every COVID-19 patient, it does offer some of the terminally ill another option for survival.”

Northwestern Medicine performs lung transplants on patients with all forms of end-stage lung diseases. Most patients eligible for lung transplants are dependent on oxygen to get through the day and suffer from pulmonary fibrosis, cystic fibrosis, chronic obstructive pulmonary disease (COPD), other advanced lung diseases, or are on a ventilator or ECMO. Following lung transplantation, more than 85-90% of patients survive one year, and report complete independence in day-to-day life.

For more information on Northwestern Medicine’s Lung Transplant Program, visit nm.org.

Photos and b-roll of the lung transplant are available on Dropbox