After suffering a severe COVID-19 infection, a patient once struggling to breathe and on life support for nearly two months became a candidate for a double lung transplant. The surgery was a success. The first one of its kind the be conducted in Latin America. Below is the story from the team’s perspective.
On the evening of August 31, a 55-year-old patient whose lungs suffered irreversible damage due to the COVID-19 disease, received a bilateral lung transplant in Monterrey, Mexico.
The first of its kind procedure to be performed in Latin America and one of the first worldwide was performed at CHRISTUS MUGUERZA Hospital Alta Especialidad.
After contracting the virus in June, the patient suffered a severe infection that led him to require mechanical ventilation because his lungs were not able to oxygenate the blood.
He was evaluated by a team of specialists from CHRISTUS MUGUERZA to determine if he was a viable candidate for a lung transplant. Various studies were carried out showing the rest of his organs were okay for this operation.
The patient waited nearly two months for a viable organ donation to come through. He was critically ill and had to eventually be connected to an ECMO (extracorporeal membrane oxygenation), a life support therapy that substitutes the functions of the lungs. This therapy played a key role in extending his chance to find compatible lungs.
“ECMO is used as a life support therapy to stabilize the patient until he can receive a lung transplant. In this case, the patient spent a little more than a month and a half in this therapy, in which, in addition to stabilizing his health, he was able to perform physical activity and be rehabilitated. Eventually we were able to temporarily remove the mechanical ventilation until the moment of donation”, explained Dr. Uriel Chavarria, medical coordinator of CHRISTUS MUGUERZA’s Lung Transplant Program.
The amount of time a patient remains intubated or on mechanical ventilation depends on the severity of the COVID-19 disease on a patient. Typically, a patient can remain intubated from 15-days to a month.
“It is very important to point out lung transplantation isn’t a treatment for COVID-19. Instead it helps with what the disease leaves behind which can be severely damaged lungs left scarred and barely functioning following an acute infection,” explained Dr. Chavarria.
“Lung transplantation is usually needed in cases of severe terminal lung conditions such as COPD, pulmonary fibrosis, cystic fibrosis, and pulmonary hypertension,” said Dr. Manuel Wong Jaén, surgical coordinator of the CHRISTUS MUGUERZA’s Transplant Program. “Without the transplant, the life expectancy of the patient was zero. Now his quality of life will be practically normal .”
Dr. Jaén performed the lung transplant and said with each passing day the patient’s condition gets better. The transplanted lungs performed correctly from the first moments after surgery. Although as a preventive measure the patient stayed on the ECMO device during the two days after transplantation. Today, the patient is conscious and in full recovery.
As in other cases of transplantation, the patient must take immunosuppressive medications to avoid rejection of the organ, as well as take a number of important safety measures to avoid any type of infection.
The surgical procedure lasted seven hours and was led by Dr. Manuel Wong Jaén, surgical coordinator of CHRISTUS MUGUERZA’s lung transplant program; Dr. Uriel Chavarria Martínez, medical coordinator of lung transplant program and leader of the Pneumology and intensive therapy team of CHRISTUS MUGUERZA; Dr. Vicente Fuentes Puga, coordinator of the Anesthesiology team; Dr. René Gómez, coordinator of the ECMO team.
Also, a multidisciplinary team made up of more than 15 people participated in this life saving operation. The CHRISTUS MUGUERZA’s Lung Transplant program is comprised of cardiothoracic surgeons, anesthesiologists, perfusionists, nursing staff, physical rehabilitators, respiratory therapists pulmonologists, nephrologists and infection preventionists.
“Lung transplantation is a life purpose. We have seen many people perish from the pandemic but being able to save some of them is invaluable. There are so many physicians who share this idea and work to make this happen. I appreciate the opportunity to work in my profession and contribute and although we still have a lot of work to increase donations in Mexico. We must give thanks to those angels and heroes who say goodbye to this world. and be thankful to the good hearts of their families. Despite sadness, joy and life can live on even after their loved ones leave this world. Without the donation of life there would be no hope,” expressed Dr. Uriel Chavarria. “I would also like to highlight the courage, bravery and will to live of our transplant patients; They will always be the reason for our work and preparation and personal pride to be able to participate in their new life opportunity. ”
“This transplant represents many things for us. It represents a reminder of the generosity of a human being, who, in moments of pain, give a gift of life by becoming an organ donation. It also reminds us that none of us, as a transplant team, is greater than the sum of all of us. This helps us remember that Mexico can be at the forefront of medicine. In the midst of this pandemic, it forces us to broaden our horizons, to go where it has not gone, to adapt to new realities, with the legitimate desire to help a patient return to enjoy life with his family and have a full life,” said Dr. Manuel Wong Jaén.
Organ and tissue donation is a voluntary and generous act and truly saves lives. Currently in Mexico, according to data from the National Transplant Center, there are 23,488 people with chronic diseases waiting for a transplant to save or improve their quality of life, which can only be obtained through a donation.
Organ donation can be done after the donor has passed away, however some organs and tissues can be donated while alive. It is reported that approximately 85 percent of transplants in Mexico are carried out from a related living donor, that is, between family members or close friends.
Living donors can potentially donate: one of the two kidneys, one of the two lobes of the liver, one lung or part of a lung, part of the pancreas or part of the intestines. Although these organs do not regenerate, both the donated portion of the organ and the portion that the donor retains are fully functional.
Currently the CHRISTUS MUGUERZA Lung Transplant Program is the only active program in Mexico
• In 2019, the first successful bilateral lung transplant was performed on a patient with Cystic Fibrosis to help repair badly damaged lungs
• In 2018 this team performed the first successful bilateral lung transplant in chronic obstructive pulmonary disease (COPD) in the history of Mexico.
• In 2017, the team performed the first successful bilateral lung transplant in the country’s history on a patient with pulmonary fibrosis. This transplant was also the first in Mexico to use ECMO as a bridge
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