Northwestern Medicine doctors

Northwestern Medicine thoracic pathologist Dr. Anjana Yeldandi, left, with Dr. Ankit Bharat, chief of thoracic surgery, were part of a team that performed the first known double lung transplant where both the donor and the recipient had been stricken with COVID-19. (E. Jason Wambsgans / Chicago Tribune/TNS)

CHICAGO – Surgeons at Northwestern Memorial Hospital last month performed the first known double lung transplant in the U.S. that used lungs donated from someone who recovered from COVID-19 to save another person who was dying of the disease, a surgery that the doctors called an “important milestone.”

The donor lungs used in the surgery came from someone who recovered from a mild case of COVID-19, but later died in an accident, according to Dr. Ankit Bharat, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program.

The case, which the doctors called a “COVID to COVID” transplant, is significant because about 30 million people in the United States have been diagnosed with the virus. If those people were ruled out as eligible donors, there would be a shortage of available lungs at a time when doctors expect the need for lung donations to increase due to the long-term health complications of some who have recovered.

“There would be a huge shortage of supply,” Bharat said, announcing the surgery during a virtual news conference Friday morning.

Though the general consensus among experts is that organs from donors who have recovered from COVID-19 can be used as long as they test negative, some transplant centers are still concerned, doctors said.

“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,” said Dr. Michael Ison, infectious diseases and organ transplantation specialist at Northwestern Medicine, in a news release.

Before the doctors decide to use a lung from a donor who  had COVID-19, they screen it to make sure the virus has cleared the body and that the lungs have no significant damage caused by the virus, Bharat said. They use several tests including testing the lung fluid and performing a biopsy of the organ.

Bharat said 20% to 30% of people who come down with the virus end up having some lung damage, including people who were asymptomatic, so the screening for the suitability of lungs is important to avoid a bad outcome.

“I suspect we’re going to see more and more transplants after the feasibility of this one from donors that have a history of COVID,” he said.

The patient who received the lungs is an Illinois health care worker in his 60s who came down with the virus in May and was on a ventilator for several months, doctors said. He spent a week on a transplant wait-list before receiving the lung donation.

Now, his new lungs are “working great” and he is on track to make a full recovery, Bharat said.

The hospital did not release the patient’s name.

Bharat and a team of surgeons in June performed the first double lung transplant in the U.S. to save a COVID-19 patient who was near death due to the virus. That patient, Mayra Ramirez, 28, is now recovering.

These lung transplants are more complex due to the extreme damage the virus wreaks on lungs in the most severe cases.

A normal double lung transplant typically takes six to seven hours, but lung transplants due to COVID-19 often take about 10 hours and require significantly more units of blood.

“It’s like a bomb blast has gone off,” Bharat told the Tribune last year, describing the lung damage of a typical patient.

To date, Northwestern has performed 14 of the surgeries for patients from across the United States. The patients face long recoveries, but so far, the hospital has seen an 100% survival rate, Bharat said.

“More patients require it,” Bharat said of the surgery. “It’s going to stress the system.

“We need to be creative to make sure we maximize our donor pool.”

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