October 8, 2020

COVID patient’s heart-lung transplant is world’s first

Vanderbilt University Medical Center has performed the world’s first dual heart-lung transplant of a COVID-19 patient.

Vanderbilt University Medical Center has performed the world’s first dual heart-lung transplant of a COVID-19 patient.

The complex procedure, completed on Sept. 24, is the first heart-lung transplant VUMC has performed since 2006.

The transplant patient, a young man, had cardiomyopathy before contracting COVID-19 in June, said Ashish Shah, MD, professor and chair of Cardiac Surgery, who performed the surgery along with Matthew Bacchetta, MD, MBA, associate professor of Thoracic Surgery.

Cardiomyopathy is a disease of the heart tissue that can lead to heart failure.

Shah said the bout with COVID-19 seriously damaged the man’s lungs and may have also further damaged his heart. By September, he was critically ill with advanced heart and lung disease, and was referred to VUMC from the University of Mississippi Medical Center by a former Vanderbilt trainee.

“He was slipping fast, in and out of the hospital and certainly by the time we operated on him, his heart was really done,” Shah said.

Bacchetta and Shah performed the transplant using both lungs and the heart from the same donor, as is standard in dual organ transplants. The patient has since left intensive care and continues to recover at VUMC, where he is doing well.

Dual heart-lung transplantation is rarely performed in the United States and typically only at high volume transplant centers. Vanderbilt is the largest heart transplant program in the United States by volume and is a national destination for complex heart and lung procedures.

In this case, the transplanted heart and lungs were from a donor infected with hepatitis C virus. VUMC was one of the first centers to use such organs for patients awaiting heart and lung transplants. It continues to lead the way in pioneering this strategy, which has significantly increased the supply of donor organs.

The transplant was the result of close coordination of the heart and lung transplant teams, including pre- and post-transplant coordinators, organ procurement coordinators, preservationists, operating room staff, in addition to cardiologists, pulmonologists, surgeons and a host of other individuals. Coordination with ICU staff was critical after the transplant.

“This transplant, like every transplant we perform, serves as a great example of the critical role of teamwork in leading to good outcomes,” said Kelly Schlendorf, MD, MHS, medical director of VUMC’s Adult Heart Transplant Program. “It really does take a village.”