Editorial by Todd Grazia, MD, Chief of Transplant Pulmonology, Baylor University Medical Center

When SARS Co-V2 arrived on U.S. shores in early 2020, physicians in all specialties faced an enormous learning curve. As many have said, we didn’t know what we didn’t know about the coronavirus. Some patients seemed to skate through the infection, while others were laid up with flu-like symptoms for a few weeks, and yet others developed severe respiratory failure from ARDS and died. Pulmonologists and intensivists were tasked with caring for and trying to treat a critical patient population whose lungs seemed to be systematically attacked, and often, permanently damaged by the virus. As the pandemic continued to rage and upend lives, transplant pulmonologists faced a daunting ethical dilemma: Should we or should we not consider lung transplantation for patients with irreversible lung damage from COVID-19?