Doctors in Japan have performed the world’s first-ever living donor lung transplant on a patient with severe lung damage from Covid-19.

A Japanese woman’s life was saved by the nearly 11-hour operation carried out by a medical team of 30 after her husband and son donated parts of their lungs, doctors said on Thursday. 

The recipient, identified only as a woman from Japan’s western region of Kansai, is recovering, Kyoto University Hospital said, along with her donor family members.

Doctors transplanted tissue from her husband and son’s healthy lungs to replace parts of the patient’s failing lungs. In the case of a live-donor transplantation, two donors are required.

Pictured: This combination of radiographs provided on April 9, 2021, by Kyoto University Hospital, shows the chest of a patient before the lung transplant surgery, left, and after the surgery, right. Doctors in Kyoto University Hospital announced Thursday, April 8, 2021

Transplants from braindead donors in Japan are still rare, and living donors are considered a more realistic option for patients. 

Covid-19 can cause severe lung damage in some patients, and people around the world have received lung transplants as part of their recovery. 

But the Kyoto hospital said it was the world’s first transplant of lung tissue from living donors to a Covid-19 patient with lung damage. 

Transplants from braindead donors in Japan are still rare, and living donors are considered a more realistic option for patients.

‘We demonstrated that we now have an option of lung transplants (from living donors),’ Dr Hiroshi Date, a thoracic surgeon at the hospital who led the operation, said at a news conference on Thursday.

‘I think this is a treatment that gives hope for patients’ with severe lung damage from Covid-19, he said.

Kyoto University said dozens of transplants of parts of lungs taken from braindead donors to patients with Covid-19-related lung damage have been carried out in the United States, Europe and China.

Pictured: Japanese doctors perform a lung transplant on a Covid-19 patient. The recipient, identified only as a woman from Japan’s western region of Kansai, is recovering, Kyoto University Hospital said, along with her donor family members

Lung transplantation

A lung transplantation, or pulmonary transplantation, is a surgical procedure in which surgeons either partially or totally replace a patient’s diseased lungs with healthy lungs that come from a donor.

Donor lungs can either be taken from a deceased or living donor. It is more common for a donated lung to come from someone who has died, but in rare cases a section of a lung can be taken from a person who is alive.

However, in the case of a lobe transplant, a living donor can only donate one lung lobe – and therefore in this case, two live donors are required.

With some lung diseases, a recipient may only need to receive a single lung, but with other diseases – such as cystic fibrosis – a recipient must be given two lungs.

In the UK, the demand for lung transplants is far greater than the available supply of donated lungs, according to the NHS.

This means that doctors must be selective about who is given a lung transplant, only choosing people who have a good chance of survival.  

The woman contracted Covid-19 late last year and developed breathing difficulties that rapidly worsened. 

She was placed on a life support machine that works as an artificial lung for more than three months at another hospital because her lungs were so severely damaged.

The university said even after she was free of the virus, her lungs were no longer functional or treatable, meaning the only remaining option was for her to receive a lung transplant. 

Her husband and son volunteered to donate parts of their lungs, and the surgery was conducted at Kyoto University Hospital by a 30-member team headed by Dr Date. 

Her husband donated part of his left lung, and son gave part of his right lung.

She is expected to be able to leave the hospital in about two months and return to her normal life in about three months, the university said.

In June last year, surgeons in the United States performed a successful double-lung transplant on a Covid-19 patient, and last month, US surgeons completed a ‘Covid to Covid’ double lung transplant – from one patient who tested positive to another.

This was a significant milestone, with Dr. Ankit Bharat, the transplant surgeon, saying ‘We will have a massive problem on our hands if Americans can’t donate their organs after having a mild to moderate case of Covid-19,’ according to CNN.

A study released earlier this year found that more than 1,700 patients in the Chinese city of Wuhan – where coronavirus is believed to have spread from – found that X-rays of severely ill patients showed evidence of lung damage months after infection. 

Like other respiratory diseases, Covid-19 can cause lung complications such as pneumonia and, in the most severe of cases, acute respiratory distress syndrome, or ARDS, and can even lead to sepsis, according to Johns Hopkins Medicine. 

When someone is inflicted with pneumonia, the lungs become filled with fluid and inflamed, resulting in breathing difficulties. This can result in people needing hospital treatment, with oxygen or a ventilator.

Air sacs in the lungs – called Alveoli – fill with fluid, limiting their ability to take in oxygen, causing shortness of breath, a cough and other symptoms.

Even after the Covid-19 infection has cleared, lasting lung damage can be left behind, resulting in breathing difficulties that can take months to improve.

In the most extreme cases, pneumonia can lead to ARDS, leaving a patient unable to breathe on their own and will likely require a ventilator to ensure oxygen still circulates the body. This can be fatal, or leave lasting pulmonary scarring.  



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