A young woman in the United States whose lungs were ravaged by Covid-19 is alive and able to talk to her family thanks to a double lung transplant, surgeons at Northwestern Memorial Hospital in Chicago announced on Thursday.
The surgery was performed on Friday last week and the patient is now recovering.
"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 hospital said it believes this is the first time such an operation on a Covid-19 patient has been performed successfully in the United States, and it offers new hope for patients with extensive lung damage from coronavirus infection.
The patient, a Hispanic woman in her 20s, spent six weeks on a ventilator and an ECMO machine while in the hospital's intensive care unit as her body fought the coronavirus infection.
"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 in a press release 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."
A need for new lungs
It was early June when the patient's lungs showed signs of irreversible damage due to Covid-19, according to the hospital.
"A lung transplant was the only option," 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."
Bharat added that before the patient could be listed for a lung transplant, she had to test negative for Covid-19.
It took about five weeks for the patient to clear the virus before her surgery -- and while normally a patient would be notified of the lung transplant surgery, it was too risky to wake up her while she was on a ventilator, her doctors said.
"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."
Doctors quickly listed the young woman for a double lung transplant once it was confirmed that she tested negative for Covid-19, and the 10-hour transplantation operation was performed 48 hours later.
The patient's family is now able to visit her in the hospital while she recovers.
"They're quite ecstatic," Bharat said. "She's able to FaceTime with her family. She's able to talk to her significant others."
'There's still so much we have yet to learn'
More research is needed to gather data on exactly how many severe Covid-19 patients could benefit from this operation, Bharat said during Thursday's press conference.
"We are one of the first health systems to successfully perform a lung transplant on a patient recovering from COVID-19," he 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."
Bharat and his colleagues also want to learn more about the patient's sickness and recovery.
"How did a healthy woman in her 20s get to this point?" Dr. Rade Tomic, a pulmonologist and medical director of the Lung Transplant Program, said in the press release.
"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," Tomic said. "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."