Trends in Lung Transplantation Practices Across the US During the COVID-19 Pandemic.

BACKGROUND: The purpose of this study is to examine the effects of the COVID-19 pandemic on adult lung transplants, and report practice changes in the US. METHODS: A retrospective analysis of a public dataset from the United Network for Organ Sharing was performed regarding adult lung transplantation (1/19/2020-6/30/2020). Data were stratified into 3 periods: pre-COVID-19 (1/19/2020 - 3/14/2020), 1-COVID-19 era (3/15/2020 - 5/8/2020), and 2-COVID-19 era (5/9/2020 - 6/30/2020). Weekly changes in waitlist inactivations (COVID-19 precautions or not), waitlist additions, transplant volume, and donor recovery were examined across eras and changes across era were correlated. RESULTS: During 1-COVID-19 era, 301 patients were added to the waitlist, representing a 40% decrease when compared to the prior 8-week period. This was followed by a significant increase in listing during the 2-COVID-19 era (t = 2.16, P = .032). Waitlist inactivations decreased in 2-COVID-19 era from the 1-COVID-19 era (t = 3.60, P < .001). There was no difference in waitlist inactivations between the pre-COVID era and the 2-COVID-19 era (P = .10). Weekly volume was not associated with trends in COVID-19 cases across any era but was negatively associated with waitlist inactivations due to COVID-19 precautions entering the 1-COVID-19 era (r = -0.73, P = .04) and 2-COVID-19 eras (r = -0.89, P = .003). CONCLUSION: Due to the COVID-19 pandemic, the US experienced a decrease in lung transplant volume. While overall volume has returned to normal, additional studies are needed to identify areas of improvement to better prepare for future pandemics.