(183) Lung Transplantation for Covid-19 Related Complications: Early Outcomes Across the United States

PURPOSE: To describe the safety and efficacy of lung transplantation for COVID-19 related acute respiratory distress syndrome (ARDS) or pulmonary fibrosis (PF). METHODS: The transplanted patient's characteristics, the donor's characteristics and the outcomes following the transplantation were extracted from the UNOS database. The overall survival (OS) was calculated using the Kaplan-Meier method and the cox proportional regression models were utilized to examine the association of the baseline characteristics with the OS. RESULTS: A total of 204 and 191 patients received lung transplantation due to COVID-19 related ARDS and PF respectively through August 2022. The majority were males (76.2%) and were identified as caucasian (55.7%). The median age and allocation score for the ARDS cohort was 47 [37, 55] and 88.3 [81.0, 91.1] wherea the PF cohort was 54 [45, 62] and 79.3 [47.7, 88.3]. There were 18 and 15 acute rejections in the ARDS and PF groups respectively during a median follow-up of 186 [63, 359] and 181 [40, 348] day. The 1-, 6- and 12- month OS was 98.4%, 95.1% and 88.3% for the ARDS arm and 96.3%, 92.2% and 83.8% for the PF arm. Receiving a graft from a smoker donor was associated with worse OS in the ARDS cohort, whereas female gender was associated with worse OS in the PF cohort. CONCLUSION: Lung transplantation is beneficial in patients with irreversible respiratory failure due to COVID-19 with survival similar to other pre-transplant etiologies.