KU Leuven transplants lungs from former Covid patient in world first

A world-first operation has taken place at Leuven University Hospital (UZ Leuven), with the successful transplant of lungs from a donor who had previously been infected with Covid-19.

The donor, a woman in her early 70s, had displayed symptoms of infection in April but was not tested due to limited capacity. She died in July of an intracerebral haemorrhage and tests showed the presence of antibodies, indicating she had previously had Covid-19.

Extensive screening showed no damage to her lungs as a result of the infection and no trace of the disease, so the organs were accepted as suitable for transplant. The recipient, a woman in her 60s with late-stage chronic obstructive pulmonary disease, was able to leave hospital after a month.

A series of follow-up tests showed no signs of lung damage, infection or reduced lung function. “The successful procedure shows that well-selected lungs can be safely transplanted after infection,” UZ Leuven lung specialist Laurens Ceulemans told VRT.

“In these difficult times,” he continued, “it is encouraging to know that lungs can recover sufficiently to qualify for a transplant and thus give another patient a second life. Following this case, we hope that more transplant centres will feel secure in evaluating such lungs when they are offered, thoroughly screening them using CT scans and, if possible, offer them for transplant.”

There were 113 lung transplants carried out in Belgium in 2019. As a respiratory disease, Covid-19 is likely to result in more patients eventually requiring transplants, while future potential donors are likely to have been infected.

Any organs taken from people previously infected with Covid-19 are carefully screened according to guidelines from the International Society for Heart and Lung Transplantation (ISHLT). Doctors are closely monitoring the results of the Leuven transplant, and Ceulemans is calling on other transplant teams to share their findings. His own team’s findings were reported in The Lancet Respiratory Medicine this week.

“It is generally accepted that lungs from a donor with ongoing SARS-CoV-2 infection should not be transplanted,” the report’s authors write. “In the case of a donor with former Covid-19, ISHLT guidelines stipulate that lungs can be assessed and considered for donation in the case of clinical recovery from Covid-19 at least 28 days from symptom onset if two PCR tests (24 hours apart) give negative results and no permanent organ damage is detected, as in our case.”

Photo courtesy VRT