Lung Transplant Recipients with COVID-19-infection Management: Systematic Review and Meta-analysis
Attapon Cheepsattayakorn1,2*, Ruangrong Cheepsattayakorn3 and Porntep Siriwanarangsun1
1Faculty of Medicine, Western University, Pathumtani Province, Thailand
210th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
3Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*Corresponding Author: Attapon Cheepsattayakorn, 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand.
Received: July 23, 2021 ; Published: August 13, 2021
A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienceDirect, PubMed, Scopus, MedRxiv COVID-19 or SARS-CoV-2, ISI Web of Science, and websites of the news. The search was applied to the articles that were published between year 2004 and half year 2021. With strict literature search and screening processes, it yielded 26 articles (2004 = 1; 2009 = 1; 2019 = 1, 2020 = 15 and half year 2021 = 8 articles) from 405 articles of initial literature database (1998-half year 2021). Currently, the Vienna Lung Transplantation Program, plays a leading role in an international consortium comprising transplantation experts from Asia, Europe, and USA. A previous cohort study among 90 solid-organ-transplant (SOT) recipients with COVID-19 infection, included 17 lung-transplant recipients (LTRs) and kidney-transplant recipients demonstrated overall mortality of about 24%. In patients awaiting for transplantation who are unlikely to receive an organ donor within 2-3 weeks, the ISHLT recommends COVID-19 vaccination, whereas the guidelines recommend a waiting period of one month post-transplantation and 3 - 6 months post-administration of B- or T-cell depleting agents and a protocol recommended 90 days for both post-transplantation and 3 - 6 months post-administration of B- or T-cell depleting agents. For the application of this issue, we now have some experience and insight for COVID-19-infected LTRs. We look forward to getting the optimal timing of COVID-19 vaccination adjustment of immunosuppression in LTRs, whereas the investigations of the T-cell response and additional COVID-19-vaccine doses are ongoing. In conclusion, Long-term outcomes of lung transplantation in severe COVID-19 patients are still to be investigated. National and international regulatory transplantation professional bodies should track the transplant-COVID-19 patient for establishing the standard guidelines.
Keywords: COVID-19; Immunization; Immunocompromization; Lung; Outcome; Risk Factor; SARS-CoV-2; Transplantation; Vaccination
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