(584) Safety of Immunosuppression Maintenance in Heart Transplant Recipients with Covid-19: A Single Center Experience

PURPOSE: Heart transplant recipients are at a very high risk of adverse outcomes after SARS-CoV-2 infection. There is no clear guidance on how to manage immunosuppression (IS) on heart transplant patients with COVID-19; in most studies IS was decreased or held. At our center, however, we deliberately maintained IS with the premise that this would result in a reduced inflammatory response to COVID-19. In this study we present our single center experience of heart transplant recipients infected with COVID-19 in whom IS was maintained. METHODS: Retrospective analysis from June 2020 to February 2022 of heart transplant recipients followed at our center that tested positive for COVID-19. Patient demographics, comorbidities, baseline IS, hospitalization, ICU need, O2 requirement, mechanical support requirement and mortality were recorded. RESULTS: During the study period, 581 transplants were followed at our center, we documented 65 cases of COVID-19 (Table 1). The average age was 58 years, 75% male, 51% Caucasian. 50% had DM, 69% HTN and 48% CKD. Median time since OHT was 4.6 years. 71% of the patients were on dual IS. All patients remained on their baseline immunosuppression. Of the 65 patients, 37% required hospitalization, 9% ICU-level of care. Median LOS was 5.5 days. Mortality was 8%, there were no events of rejection or allograph dysfunction. CONCLUSION: Our data suggest that maintenance of therapeutical levels of IS in patients with COVID-19 is safe in heart transplant recipients. Our outcomes were comparable to those of the existing literature. Larger studies are needed to further validate our results.