Indian origin doctor performs first ever double lung transplant in Covid 19 patient

Chicago, IL – A doctor of Indian origin Dr Ankit Bharat led team of surgeons at Northwestern Medicine and for the first time performed a double-lung transplant on a patient whose lungs were damaged by COVID-19.

The disease caused by the new coronavirus most commonly attacks lungs and respiratory system adversely and this was a life saving endeavor on the part of medical team.

There were a number of challenges to overcome including the one that patient testing negative for Covid 19 before embarking on the surgery.

The patient, a 20 year old Hispanic woman spent six weeks in the COVID ICU on a ventilator and extracorporeal membrane oxygenation (ECMO), a life support machine that does the work of the heart and lungs. By early June, the patient's lungs showed irreversible damage. The lung transplant team listed her for a double-lung transplant, and 48 hours later, performed the life-saving procedure at Northwestern Memorial Hospital.

"A lung transplant was her only chance for survival," says Ankit Bharat, MD, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program. "We are one of the first health systems to successfully perform a lung transplant on a patient recovering from COVID-19. 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."

Before putting the patient on the transplant wait-list, she had to test negative for COVID-19.

"For many days, she was the sickest person in the COVID ICU – and possibly the entire hospital," explains Beth Malsin, MD, pulmonary and critical care specialist at Northwestern Memorial Hospital. "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. 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 and become eligible for a life-saving transplant."

"Due to the ability of Northwestern Medicine's ECMO program to support patients with life-threatening lung failure for extended durations, the patient could get adequate time to clear the virus from her body, allowing the consideration of transplantation," adds Dr. Bharat.

However, during her stay in the COVID ICU at Northwestern Memorial Hospital, while her body cleared the virus, her lungs were damaged beyond repair.

"How did a healthy woman in her 20s get to this point? There's still so much we have yet to learn about COVID-19. Why are some cases worse than others? The multidisciplinary research team at Northwestern Medicine is trying to find out," says Rade Tomic, MD, a pulmonologist and medical director of the Lung Transplant Program.

"COVID-19 results in significant damage to the lungs of patients were severe disease," adds Michael Ison, MD, infectious diseases and organ transplantation specialist at Northwestern Medicine. "Opening the door to patients who have recovered from the infection to lung transplantation offers a potential path to recovery."

Northwestern Medicine has one of the shortest wait-times in the United States for new lungs, according to Dr. Tomic. Once a patient's name is added to the transplant waiting list, it typically takes 30 days to find a match – much shorter than the national average of three months.

"The fact that we were able to transplant this patient quickly and safely, is a testament to the infrastructure and expertise of our clinical care and research teams," says Dr. Tomic. "While this young woman still has a long and potentially risky road to recovery given how sick she was with multi-organ dysfunction for weeks preceding the transplant, we hope she will make a full recovery."

Northwestern Medicine performs lung transplant procedures on patients with all forms of end-stage lung diseases. Most patients eligible for lung transplants are dependent on oxygen to get through the day and suffer from pulmonary fibrosis, cystic fibrosis, chronic obstructive pulmonary disease (COPD), other advanced lung diseases, or are on a ventilator or ECMO. Following lung transplantation, more than 85-90% of patients survive one year, and report complete independence in day-to-day life.

For more information on Northwestern Medicine's Lung Transplant Program, visit nm.org.