Lung transplantation is successful for patients with COVID-19- associated acute respiratory distress syndrome (ARDS), according to a study published in the Journal of the American Medical Association. Chitaru Kurihara, MD, and colleagues assessed 102 patients who underwent a lung transplant between January 21, 2020 and September 30, 2021, including 30 patients with COVID-19-associated ARDS. Median lung allocation scores were 85.8 versus 46.7 for transplant recipients with versus without COVID-19, among whom 56.7% and 1.4%, respectively, used ECMO. Intraoperative venoarterial ECMO was used by 96.7% and 62.5% of patients with versus without COVID19, respectively. Rates of primary graft dysfunction within 72 hours were 70.0% versus 20.8% for the COVID-19 cohort versus those without COVID19; median time receiving invasive mechanical ventilation was 6.5 versus 2.0 days, with 13.3% and 5.5%, respectively, requiring permanent hemodialysis. Antibody-mediated rejection was demonstrated by none of those with COVID-19-associated ARDS versus 12.5% of those without COVID19. At follow-up, all COVID-19-associated ARDS lung transplant recipients were alive, compared with 83% in the non-COVID-19 cohort.

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