How a COVID-19 Procedure Helps the Case for Better Lung Transplant Use

Ankit Bharat, MD

In late May, a surgery team at the Northwestern Medicine Lung Transplant Program executed a medical marvel: the first double lung transplant in the US for a severely ill patient with coronavirus 2019 (COVID-19).

Ankit Bharat, MD, chief of thoracic surgery and surgical director for the program, shared the incredible story on the September episode of Lungcast, highlighting what his team has found to be foundational evidence for a last-ditch procedure for patients failing to recover from the virus.

Though the successful transplant set a precedent for COVID-19 care, Bharat also sees it helping to confront another great US public health issue: the underutilization of donor lungs.

“Only 15% of all the lungs coming from donors get utilized,” he explained. “We have a huge opportunity to understand donor management and improve the utilization of those lungs.”

Approximately 2700 lung transplants were performed in the US last year, Bharat said—with many more opportunities for procedures left unanswered, and an even greater count of donor lungs expired.

Many factors influence the minimal rate of lung transplants, and one that seems to be a self-perpetuating issue is the mortality risk, which Bharat said is approximately 10% now.

“But the gap can absolutely be overcome by how many donors are already there,” Bharat said. “I don’t personally think that’s a challenge we can’t overcome.”

Along with showing capability to better a respiratory distress-generating disease like COVID-19, surgeons have become capable of safely transplanting hepatitis C patient donor lungs—a previously taboo practice—as well as using ex vivo lung perfusion circuits to give second life to donor lungs.

“We certainly hope with the success we’ve had, and other centers on the east coast and west coast similarly performing these transplants and getting these patients through, the OPTN (Organ Procurement and Transplantation Network) includes COVID-19 as a diagnosis code in their registration of these recipients,” Bharat said.

Listen to Bharat’s perspective on improving lung transplants, as well as his team’s miraculous procedure, on Lungcast.