TORONTO -- Doctors have successfully completed the first double lung transplant in Canada for a man whose lungs were devastated by COVID-19.
Tim Sauve, 61, became ill with COVID-19 in December when he noticed himself getting dizzy at home in Mississauga, Ont. In a matter of days he ended up in hospital, unable to breathe.
鈥淚 was put on 100 per cent oxygen at that moment, and after that there was no turning back, they could not lower my oxygen鈥 Sauve told 麻豆影视鈥 chief medical correspondent Avis Favaro. 鈥淎t that point it got very, very serious.鈥
Sauve was transferred to the intensive care unit (ICU) at Toronto General Hospital in January with acute respiratory distress syndrome - or lung failure 鈥 caused by COVID-19. At that time, he was also put on extracorporeal membrane oxygenation (ECMO) which is a treatment that pumps the blood outside the body into an artificial lung to become oxygenated and then cycles it back into the patient, basically providing heart-lung bypass support.
鈥淗e had really no prospect of recovery as far as we could tell, things looked pretty dire and it looked quite unlikely that he would be able to pull through,鈥 said respirologist and member of the Toronto General Hospital lung transplant program Dr. Stephen Juvet to 麻豆影视.
Sauve鈥檚 other organs were not failing, but there was little chance his lungs would recover, which is why doctors offered him a chance at survival with a transplant.
Dr. Marcelo Cypel, a thoracic surgeon at the University Health Network told 麻豆影视 that Sauve had such intense scarring in his lungs from the disease and with two and a half months with no improvement in the ICU, his medical team felt 鈥渉is only chance of surviving was by a lung transplantation.鈥
In mid-February, Sauve became the first COVID-19 patient in Canada to receive a double lung transplant.
Cypel said it was a close call. 鈥淚 don鈥檛 think if we didn鈥檛 get lungs for him for another five to seven days, probably he would not be a candidate anymore.鈥
Sauve said he feels like 鈥渁 million dollars鈥 after the operation. He鈥檚 lost 30 pounds and says 鈥渆veryone鈥 was surprised at his quick recovery.
Approximately 40 lung transplants have been performed for COVID-19 patients globally, a procedure that is considered high-risk with life-long medications necessary to prevent organ rejection.
The rise in variants of concern in Canada and their tendency to infect a younger cohort of patients means that lung transplants for severe COVID-19 cases could become more common.
Dr. Shaf Keshavjee, surgeon-in-chief at University Health Network in Toronto and director of the Toronto Lung Transplant Program said it鈥檚 a watch and wait situation.
鈥淲e had a meeting with the other transplant centres in Canada, and they鈥檙e sort of looking and waiting, watching what to do鈥nowing that they鈥檙e very difficult and high-risk transplants to do,鈥 he said.
But lung transplants for COVID-19 patients means adding even more people to the already long transplant lists, diminishing the odds for people already waiting 鈥 and doctors can鈥檛 reliably predict whose lungs will recover on their own.
鈥淲hen do you resort to transplant is really answering the very difficult question: When is the lung irreparably damaged?鈥 Keshavjee said. He added that in the past, ECMO could keep a patient alive for 鈥渇our to six weeks鈥 but now works for six to seven months.
鈥淲e鈥檝e seen lungs recover in three, four or five months, they get off ECMO and go home to their lives, so when do you jump to transplant? How do you know that the lung is irreparably damaged 鈥 a lot of lungs can look really bad on CT scans and X-rays and recover,鈥 he said.
In Sauve鈥檚 case, his lungs started to heal 鈥渋n the wrong way鈥 and he developed severe scarring and fibroids, Keshavjee said. 鈥淭hat鈥檚 when we started to have the discussion that 鈥測ou know, your only way out of this is with a transplant.鈥
Sauve is hoping to return home in a few months, but issued a stark warning from his hospital bed after his family all contracted COVID-19. His future father-in-law, 80-year-old Juanito Teng died, but his partner Julie Garcia and her son did not become ill at all.
鈥淚t鈥檚 an opportunity for me to tell people, don鈥檛 take your guard down for one minute,鈥 Sauve said. 鈥淚t is so powerful, and it鈥檚 so quick. It鈥檚 unbelievable. I don鈥檛 wish this upon anyone ever.鈥
