Efficacy of convalescent plasma for the treatment of COVID-19 in lung transplant recipients: A multicenter French study.

Introduction: Lung transplant (LT) recipients are at greater risk of complications from COVID-19. Treatment options are limited partly due to interactions with immunosuppressive agents. Convalescent plasma (CP) is a potential treatment option, but it has not been extensively studied in LT patients. We aimed to assess the efficacy and safety of CP use in France for COVID-19 infected LT patients.

Material and methods: We retrospectively recruited LT patients followed up in the 10 French LT centers, older than 18 years, infected with SARS-CoV-2 between the pandemic onset and July 1, 2023, and treated with high-titer CP.

Results: We collected the data from 27 patients who received CP for a COVID-19 infection in six out of the 10 French LT centers. The average delay between symptom onset and CP administration was 19.5 days, and 51.8 % of patients received four units. In patients treated within the first 9 days of infection, the survival rate was 100 % at one and three months vs. 75 % (p = 0.28) for late administration patients. Average loss of forced expiratory volume in 1 second at three months was 10.5 % in the early group vs. 3.3 % in the late group (p = 0.58). The average length of hospital stay was 18 and 24 days respectively (p = 0.07). Early use of CP was also more frequent in 2023.

Discussion: In this study highlighting the French experience for the use of CP in LT patients, we observed a limited, heterogenous but well-tolerated use of this therapy.