Featuring: Ankit Bharat, MBBS
One of the first-known “COVID to COVID” double-lung transplants
Northwestern Medicine surgeons have successfully performed a double-lung transplant on a COVID-19 patient using lungs from a donor who previously had COVID-19. The transplant recipient, an Illinois man in his 60s, received lungs from a donor who cleared the virus after having mild to moderate COVID-19 symptoms. The donor’s death was unrelated to COVID-19 and their lungs didn’t suffer any permanent damage from the virus, making them viable for transplantation.
“This is a milestone for lung transplantation,” says Ankit Bharat, MD, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program, who performed the procedure. “To date, 30 million Americans have had COVID-19 and many of them are registered organ donors. If we say ‘no’ to them just because they had COVID-19 in the past, we will drastically reduce the donor pool and there’s already a big supply and demand gap. We will have a massive problem on our hands if Americans can’t donate their organs after having a mild to moderate case of COVID-19.”
To ensure the donor had cleared the virus from the body, the lung transplant team performed a test that examines the donor’s lung fluid. This same test has been performed before every lung transplant procedure at Northwestern Memorial Hospital during the COVID-19 pandemic. The team also performs a lung biopsy in the operating room to make sure there’s no permanent damage to the donor lung.
“Studies have shown that if your nasal swab is negative 8-10 days out of your COVID-19 symptoms you don’t have any live virus in your airways, but that nasal swab doesn’t confirm if you’ve cleared the virus from your lungs,” explains Dr. Bharat. “We can’t rely on a nasal swab alone to see if the donor has cleared the virus – we have to check the lung fluid. If the swab and lung fluid both come back clear of the virus and the lung biopsy confirms there’s no permanent damage to the lungs, we can feel confident in the quality of the donor lungs. Our first ‘COVID to COVID’ patient received beautiful, healthy lungs and continues to recover at optimal pace.”
The patient, who works in health care, was diagnosed with COVID-19 in May 2020 and suffered permanent lung damage. He was placed on a ventilator and extracorporeal membrane oxygenation (ECMO), a life support machine that does the work of the heart and lungs, before being transferred to Northwestern Memorial. After spending one week on the transplant wait-list, the patient received the life-saving procedure in February, becoming one of the first-known COVID-19 survivors in the United States to receive lungs from a donor who recovered from the virus.
“Current consensus guidelines are that donors with a history of COVID-19 can be used for organ transplantation as long as they have clinically recovered and have negative testing,” says Michael Ison, MD, infectious diseases and organ transplantation specialist at Northwestern Medicine. “But currently, many transplant centers are worried about the risk of transmission of COVID-19 from donors, particularly for lung transplants, and are unnecessarily discarding these organs. This donor clarifies the safety of the use of these donors.”
Since the start of the pandemic, Northwestern Medicine surgeons have completed 14 double-lung transplants on COVID-19 survivors – the most performed at any hospital in the world. Their first double-lung transplant for a COVID-19 patient happened in June 2020, which was the first-known time in the United States.
“We’re optimistic that all 14 patients will make a full recovery and return to their daily lives,” says Rade Tomic, MD, pulmonologist and medical director of the Lung Transplant Program. “But we need to have a serious conversation about the future of lung transplantation. With many COVID-19 survivors still suffering long-term effects of the virus, the need for transplantation will continue to grow. We should not immediately disregard organ donors who had mild cases and fully recovered from COVID-19; especially when millions of young Americans contracted the virus.”
For more information on Northwestern Medicine’s Lung Transplant Program, visit nm.org.
This article was originally published in the Northwestern Medicine Newsroom on March 19, 2021 .
Ankit Bharat, MBBS, is the chief of Thoracic Surgery in the Department of Surgery, Harold L. and Margaret N. Method Research Professor of Surgery and associate professor of Surgery (Thoracic Surgery) and Medicine (Pulmonary and Critical Care). Dr. Bharat specializes in malignant and benign chest and esophageal diseases. His research focuses on lung preservation, transplant immunology and airway biology, achieved through collaboration with the Kovler Comprehensive Transplant Center and the Division of Pulmonary and Critical Care Medicine.
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