CHICAGO — Doctors at Northwestern Memorial Hospital on June 5 performed the first known double lung transplant in the United States for a COVID-19 patient whose lungs were severely damaged by the disease, saving the woman in her 20s from almost certain death.
Speaking outside of the Prentice Women’s Hospital on Thursday, the doctors called the surgery a “milestone” in care for patients who are critically ill from the virus which has killed more than 6,000 people in Illinois. The hospital has already received calls from across the country about the procedure.
At least two other transplants have been performed in Austria and China.
“This is an important development that could help a number of patients who have sustained severe and irreversible lung damage as a result of COVID-19,” said Ankit Bharat, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program.
Although lung transplants are not new on their own, the damage to the woman’s lung from COVID-19 made the surgery “technically much more complex,” said Bharat, who performed the surgery with a team.
The doctors also had to wait for the virus to clear the woman’s system while mechanically supporting her body, which was on the brink of multi-organ failure.
“If she didn’t get the transplant, she would not be alive,” Bharat said.
The woman, among the youngest patients at Northwestern with that degree of lung damage, spent about six weeks in the COVID-19 intensive care unit on a ventilator and another life support machine to support her heart, doctors said.
“Many days, she was the sickest patient in our COVID-19 ICU, and possibly the entire hospital,” said Elizabeth Malsin, pulmonary and critical care specialist at Northwestern Memorial Hospital.
The woman required a ventilator “almost immediately” after arriving at the hospital, Malsin said, an indication of how quickly the virus overwhelmed her lungs.
‘She was never alone’
Machines supported her body for more than a month, as doctors hoped her lungs would eventually heal and allow her to breathe on her own, Malsin said. Hundreds of health care workers provided care for her over several weeks.
The woman was not able to have her family beside her through the ordeal because of COVID-19 visitor restrictions, leaving health care workers to take up roles of comfort and support, Malsin said.
“Even on her sickest days, she was never alone,” she said.
By early June, her lungs were showing signs of irreversible damage, leaving a transplant as the only option.
Generally doctors try to wake up transplant patients so they can be made aware of the surgery, but in this case, the hospital had to rely on her family for consent, Bharat said.
“Her lungs were so badly injured we could not wake her up,” he said.
About 48 hours after listing her for a transplant, the team found a matching donor, Bharat said.
A normal double lung transplant generally takes six to seven hours, but this transplant was complicated by extensive scarring on the lungs, Bharat said, highlighting how much doctors still don’t know about the effect of the virus.
“COVID-19 is a disease unlike anything we’ve seen before,” he said. “One minute the patient is talking to you and looks comfortable, and the next minute, the patient’s oxygen starts to drop and the patient suddenly requires ventilation and intubation.”
There are about 113,000 people in the United States waiting for a life-saving organ transplant, said Rafael Garza-Castillon, a thoracic surgeon at Northwestern Memorial Hospital, who asked people to consider becoming a donor.
“Please consider checking that box on your driver’s license,” he said.
The woman is currently in stable condition. Although she has a long road ahead, Bharat said he hopes she will make a full recovery.
“Yesterday she smiled and told me just one sentence,” he said. ” ‘Thank you for not giving up on me.’ “
