(418) Long-Term Impact of Covid-19 Infection Among Solid Organ Transplant Recipients

PURPOSE: The short-term outcome of solid- organ transplant recipients infected with Covid-19 has been described extensively, but the long-term impact has yet to be described. The aim of this study is to describe the long- term impact of Covid-19 infection on heart, liver, and kidney transplant recipients. We retrospectively assessed whether transplant recipients who were diagnosed with Covid-19 have experienced decrease in their transplant function over time. METHODS: All active patients who have undergone solid-organ transplant at UTMB Galveston who met inclusion criteria were retrospectively analyzed, including 120 liver transplant recipients (30 Covid-19 +, 90 Covid-19 -), 30 heart transplant recipients (10 Covid-19 +, 20 Covid-19 -), and 220 kidney transplant recipients (60 Covid-19 +, 160 Covid-19 -). Heart transplant function was assessed utilizing pre and post- infection LVEF. Kidney transplant function labs included GFR, Creatinine, and BUN. Liver transplant function labs were also analyzed and included ALT and AST. Pre- infection data was gathered and compared to data at at least 6 months post-infection and all subsequent data after 6 months. RESULTS: At an average of 1 year post-infection with Covid-19, a statistically significant decrease in ejection fraction was observed among heart transplant recipients when compared to their own pre-infection baseline EF (p= .05). Kidney transplant function showed no statistically significant change in GFR, BUN, or Cr 6 months to 3 years after Covid-19 infection. Liver transplant recipients infected with Covid-19 were determined to have statistically insignificant increases in ALT and AST (p=.09, .1). Mortality was unchanged in solid organ transplant recipients infected with Covid-19 versus those not infected. However, a trend was noted for increased mortality among infected versus not infected liver transplant recipients (p=.09). CONCLUSION: Heart transplant recipients infected with Covid-19 had statistically significant decreases in LVEF long-term, without effect on mortality. No change was observed among kidney transplant recipients. Among liver transplant recipients, there was a statistically insignificant increase in AST and ALT post-infection and increased mortality among infected patients. This study is one of the first to describe the long-term effects of Covid-19 infection on solid organ transplant recipients.