Surgeons at Northwestern Memorial Hospital were able to announce this week that a young Covid-19 patient has successfully recovered from a double lung transplant. The young woman’s lungs were ravaged by coronavirus and she spent weeks fighting for her life on a ventilator but is now recovered and ‘able to speak with her family’.
The surgery was performed at Northwestern Memorial on Friday last week and the hospital claims it is the first double lung transplant to be successfully performed on a Covid-19 patient in the USA.
“The patient is in stable condition and improving every day. While she still has a long road ahead of her, I’m extremely hopeful that she’s going to make a full recovery,” Dr. Ankit Bharat, chief of thoracic surgery and surgical director at the Northwestern Medicine Lung Transplant Program, said during a press conference in Chicago on Thursday.
“Yesterday she smiled and told me this one sentence. She said, ‘Doc, thank you for not giving up on me,'” Bharat said. “If she didn’t get the transplant, she would not be alive.”
The patient is a Hispanic woman in her 20s who was forced to battle the disease for weeks on a ventilator and ECMO machine, which is a life support machine that is used to replicate the workings of the heart and lungs.
“For many days, she was the sickest person in the Covid ICU – and possibly the entire hospital,” Dr. Beth Malsin, pulmonary and critical care specialist at Northwestern Memorial Hospital, said during the hospital’s press release on Twitter on Thursday.
“There were so many times, day and night, our team had to react quickly to help her oxygenation and support her other organs to make sure they were healthy enough to support a transplant if and when the opportunity came,” Malsin said. “One of the most exciting times was when the first coronavirus test came back negative and we had the first sign she may have cleared the virus to become eligible for a life-saving transplant.”
As May turned into June, the patient’s condition failed to improve, and irreversible signs of damage started to appear on her lungs. The damage that Covid-19 was inflicting on the lungs started to have drastic consequences everywhere else on the patient’s body, and soon it became clear that there was no option but to transplant the lungs.
“A lung transplant was the only option,” Northwestern Memorial Hospital’s Dr. Bharat said.
“She was starting to develop multi-organ failure from the result of the permanent damage that she had,” he said. “As a result of the severe injury, the pressure inside the lungs started to really go up and the heart then started to fail – and when the heart starts to fail then the blood starts to back up, so the liver starts to fail and then the kidney starts to fail.”
Before a patient can be cleared for a lung transplant, they must test negative for Covid-19 so it was a tense wait to see if the patient could survive until the disease had cleared her system. It took five weeks before the patient tested negative for the virus and so was ready for the surgery but waking her up to notify beforehand was too risky while she was on a ventilator.
“Normally we try to wake every patient up before we offer them lung transplant. We want to make sure that the patient knows,” Bharat said.
“In her situation, we tried to do the same thing, but her lungs were so badly injured we just could not wake her up,” he said. “We had to rely on her family, her power of attorney, her mom and her caregivers to understand her wishes and that’s what helped us make the decision. It’s an unusual situation in her case.”
After the patient finally tested negative for Covid-19, doctors placed her on the waiting list for a double lung transplant, and 48 hours later the young woman was prepared for surgery. The transplantation operation took in excess of 10 hours but just days later the patient’s family were able to visit and talk with her as she recovered.
“They’re quite ecstatic,” Dr. Bharat continued on Twitter. “She’s able to FaceTime with her family. She’s able to talk to her significant others.”
Being the first such operation in the USA, this procedure gives hope to many that heavy sufferers of Covid-19 may be able to have their lives saved in the same way. More research is yet needed on exactly which of those severe patients will be able to benefit from the same surgery.
“We are one of the first health systems to successfully perform a lung transplant on a patient recovering from COVID-19,” Bharat said. “We want other transplant centers to know that while the transplant procedure in these patients is quite technically challenging, it can be done safely, and it offers the terminally ill COVID-19 patients another option for survival.”