THURSDAY, December 16, 2021 (HealthDay News) – After nearly dying from a severe case of COVID-19, a young man received a successful heart transplant even as he recovered from his infection while on a ventilator , a new case study reports.
The transplant was performed on the 31-year-old patient at Israelita Albert Einstein Hospital in Sao Paulo, Brazil, in May.
This is one of the first cases of its kind in the world and shows that heart transplants can be successful after a severe infection with COVID-19, according to Dr Eduardo MocsÃ¡ri, one of the anesthesiologists on the transplant team.
After being diagnosed with hereditary cardiomyopathy a few years ago the patient had developed heart failure and was due to receive a new heart. But he tested positive for COVID-19 when he was admitted to hospital for his transplant, resulting in his postponement.
He developed respiratory failure from COVID-19 and was put on a ventilator. He then developed cardiogenic shock – a life-threatening condition in which the heart suddenly cannot pump enough blood to meet the body’s needs – and he was put under ECMO, a machine that replaces the function of the heart and lungs.
Even though the man had not fully recovered from COVID-19, his heart continued to worsen and doctors decided that having his heart transplanted was his best chance for survival.
The transplant was performed 42 days after the patient was diagnosed with COVID-19. He tested negative for the coronavirus at the time of his transplant, but still needed a ventilator and ECMO. Members of the transplant team wore full personal protective equipment (PPE) during the five-hour procedure.
The man spent 20 days in intensive care and was discharged from hospital 66 days after his Heart transplant, according to the case study which will be presented online Wednesday at the annual meeting of the European Society of Anesthesiology and Critical Care (ESAIC). Research presented at the meetings is considered preliminary until it is published in a peer-reviewed journal.
The patient developed a complication, necrosis of his toes, which resulted in the amputation of some of his toes, and he will need to take immunosuppressive drugs for life to avoid rejection of his new heart.
Currently, the man is hospitalized with an abdominal infection, but has responded well to treatment and is on the verge of discharge.
“Heart transplantation after COVID-19 infection is something new and we are still learning about the risks and complications,” MocsÃ¡ri said in a press release.
“In this case, the patient had not fully recovered and we were concerned that his COVID was getting worse. Several studies have indicated that transplant patients are at a greater risk of more severe COVID and of dying from the disease,” MocsÃ¡ri noted. “But, as her heart was still deteriorating, we decided that the transplant gave her the best chance of survival.”
This case study shows that “despite the few reports in the literature, heart transplantation in patients who have had severe COVID-19 may have a favorable outcome,” MocsÃ¡ri concluded. “There are situations where, despite all the unknowns, a transplant is the best option. It’s by pushing boundaries like these that discoveries – and medical breakthroughs – are made.”
The National Heart, Lung, and Blood Institute in the United States has more information on heart transplants.
SOURCE: European Society of Anesthesiology and Critical Care, press release, December 15, 2021