Management of Lung Transplantation in the COVID-19 Era

An International Survey

Benjamin Coiffard; Philipp M. Lepper; Eloi Prud'Homme; Florence Daviet; Nadim Cassir; Heinrike Wilkens; Sami Hraiech; Frank Langer; Pascal A. Thomas; Martine Reynaud-Gaubert; Robert Bals; Hans-Joachim Schäfers; Laurent Papazian; Frederik Seiler


American Journal of Transplantation. 2021;21(4):1586-1596. 

In This Article

Abstract and Introduction


It is unknown if solid organ transplant recipients are at higher risk for severe COVID-19. The management of a lung transplantation (LTx) program and the therapeutic strategies to adapt the immunosuppressive regimen and antiviral measures is a major issue in the COVID-19 era, but little is known about worldwide practice. We sent out to 180 LTx centers worldwide in June 2020 a survey with 63 questions, both regarding the management of a LTx program in the COVID-19 era and the therapeutic strategies to treat COVID-19 LTx recipients. We received a total of 78 responses from 15 countries. Among participants, 81% declared a reduction of the activity and 47% restricted LTx for urgent cases only. Sixteen centers observed deaths on waiting listed patients and eight centers performed LTx for COVID-19 disease. In 62% of the centers, COVID-19 was diagnosed in LTx recipients, most of them not severe cases. The most common immunosuppressive management included a decreased dose or pausing of the cell cycle inhibitors. Remdesivir, hydroxychloroquine, and azithromycin were the most proposed antiviral strategies. Most of the centers have been affected by the COVID-19 pandemic and proposed an active therapeutic strategy to treat LTx recipients with COVID-19.