ABSTRACT
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. 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. 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. 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. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)