Lung transplants for COVID-19 patients are rising quickly

 

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Once rare, lung transplants for COVID-19 patients are rising quickly

(NPR)-About one in 10 lung transplants in the United States now go to COVID-19 patients, according to data from the United Network for Organ Sharing, or UNOS.

The trend is raising questions about the ethics of allocating a scarce resource to people who have chosen not to be vaccinated against the coronavirus.

«They are accumulating on a steady basis. So it’s very much a real thing,» says David Klassen, chief medical officer for UNOS.

«If there were more lungs available for transplants, I believe the numbers would be greater than they are,» he says.

In all, 238 people across the country have received lung transplants due to COVID-19 since the first such operations were tracked in August of 2020, according to the latest UNOS figures from October of this year.

Lung transplants for COVID patients rose tenfold between the first year of the pandemic and 2021, according to UNOS data, which also shows transplants for other top lung diseases, like emphysema, cystic fibrosis and pulmonary fibrosis, are down compared to prior years.

«It’s happening in the U.S. It’s also happening in Canada. There was just a paper out from Western Canada about this causing a huge surge in the number of lung transplants there. It’s a big problem,» says David Mulligan, chair of the Yale-New Haven Health Transplantation Center.

More than 2,000 lung transplant operations are usually done each year in the U.S., costing around $1.2 million for a double lung transplant.

The rise in COVID-related transplants is forcing doctors to grapple with how to best manage who gets them, especially now that vaccines are widely available.

«When somebody contracts such severe COVID that they need a lung transplant, and they got it refusing to get a vaccine, it’s a really ethical dilemma,» says Mulligan. «How can they just jump in and take a lung away from somebody who’s sick, but has been doing the best they can to take care of themselves and avoid getting COVID?»

Some transplant centers have said patients will lose their spot on the list if they are not vaccinated against coronavirus.

But some say eliminating anyone who hasn’t had a COVID vaccine from even being considered for an organ may be unfair because it could exclude racial, religious or ethnic groups that have lower vaccination rates.

There is no national, overarching policy on how to handle vaccine refusal when it comes to transplants.

The American Society of Transplant Surgeons recommends vaccination for anyone awaiting a transplant.

Doctors say that’s because the immune response is stronger if a patient gets the vaccine before, rather than after, their transplant.

People who live with donated organs must take immune-suppressing drugs for life in order to prevent their bodies from attacking and rejecting the new organs, making them more vulnerable to COVID-19 as long as it’s around.

Source: NPR, 28/11/2021

Last Updated on 29.11.2021 by iskova