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The historical patient is a man born in the mid-1960s, who lives in the Stockholm area and was previously completely healthy. In May, he falls ill in Stockholm and ends up in the intensive care unit for covid-19.
– After that, you will be admitted to Ecmo in mid-June, says surgeon Göran Dellgren.
Ecmo – Extracorporeal Membrane Oxygenation – is a cardiopulmonary machine that oxygenates the blood outside the body. Treatment is given to patients with temporary insufficiency of the lungs, the heart, or both, as regular intensive care is not enough. During treatment, the lungs and heart have a chance to heal. But despite 140 days of Ecmo, the lungs of patients do not heal.
– Everyone expects him to recover, but he never does, says Göran Dellgren.
Is in this the stage where the man is first screened for suitability and finally accepted for inclusion on a waiting list. When suitable donor lungs are identified, the patient goes to the Gothenburg and Sahlgrenska Transplant Center, one of two clinics in Sweden (together with Lund) that performs lung transplants. On September 24, the patient’s lungs are replaced with a pair of lungs from a deceased person.
– The patient is up and has begun to move, but is not yet in normal condition. It takes a lot of training to continue, says Göran Dellgren.
The man has been doing initial training for just over a month in Sahlgrenska, but now he is being transferred to the Stockholm region for rehabilitation.
He is relatively young and has been completely healthy. How could he get so sick?
– I don’t think we can say why. Maybe eventually, says Göran Dellgren.
What is even more certain is that his relatively young age and solid basic health were crucial to undergoing the lung transplant.
– There are not many that can be considered. Those who are not too old and who are believed to have a good life to return to, may be subject to this treatment. But then we’re talking about a few in Sweden, says Göran Dellgren, who describes the operation itself as a routine procedure.
– We have handled his destroyed lungs like we handle all destroyed lungs, only now it turns out to be covid. For him it is great, and for the public it is great news, but for us it really “continues as usual”.
Jesper Magnusson, chief physician of pulmonary medicine, chief physician Martin Silverborn at the transplant center, nurse Lina Wessmark, Elin Olsson, assistant physician, and Göran Dellgren, professor and chief physician of the transplant center. Martin Silverborn and Göran Dellgren performed the transplant. The others in the picture have cared for the patient in relation to the transplant.
Photo: Sírnir Einarsson
Göran Dellgren evaluates that a dozen lung transplants have been performed in patients with Ecmo covid in the world, in addition to the now first case in Sweden. At Sahlgrenska, approximately 40-50 lung transplants are performed annually, with the help of organs from the deceased.
– There is always a great need for donors and it is important that as many people as possible donate, says Göran Dellgren.
He thinks that all citizens should think about how to relate to organ donation and make sure that even family members know what position they have taken, in case the worst happens.
– Most people who get seriously ill and need a transplant don’t say no. So most people should also be positive about allowing organ donation, if you end up in the unlikely condition of brain death – that is, lying on a ventilator in an intensive care unit when the brain stops working, he says. Göran Dellgren.
– Becoming an organ donor and being able to donate organs is a fantastic gift for a terminally ill person if you don’t have a chance to survive yet.
