(593) Utilization of Lung Transplantation in Patients with Covid-19

PURPOSE: Lung transplantation (LTx) had been the only survival option in selected Covid-19 infected ARDS patients. We evaluated surgical outcome in such group from multi-center ECLS study. METHODS: LTx patient data (n=1488)were collected from multiple institutions through the National ECLS Registry and was stratified on presence of COVID-19 infection. LTx procedure details, patient demographics and post-operative outcomes were compared between COVID-19 and non-COVID-19 patients along with pre-op ECMO vs. no ECMO COVID-19 patients using Wilcoxon rank sum test or Chi-square testing to determine distribution. Time to 30-day post-operative survival was analyzed in combination with Kaplan-Meier survival curves with log-rank testing to assess mortality in these groups of patients. P values <0.05 were considered statistically significant. RESULTS: Out of 1488 LTx patients, our results included a total of 34 patients infected with COVID-19 at time of LTx. When compared between covid LTx (n=34) vs. non-covid LTx (n=1,454), demographic data revealed significant differences in tracheostomy (p=0.0001), lung allocation score (p=0.0001), type of pre-op ECMO support (p=0.0001), type of ECMO support (p=0.001), conversion (p=0.006), and ventilator support time (p=0.0001); but no significant differences in gender (p=0.30), BMI (p=0.32), EVLP (p=0.078), PGD score at T24 (p=0.13), and waitlist time (p=0.75). 30-day post-operative mortality analysis showed K-M graph with no statistical significance (p=0.41) in COVID-19 and non-COVID-19 patients. In addition, we compared pre-ECMO utilized COVID-19 patients (n=21) vs. non-ECMO utilized COVID-19 patients (n=13) who were transplanted. CONCLUSION: Covid-19 infected patients when transplanted showed no significant differences in survival. Propensity score matched study indicated similar results. Selective ARDS patients may benefit from end-stage surgical options like lung transplantation.