Lung Transplantation During the COVID-19 Pandemic: Safely Navigating the New "Normal".

Halpern, Samantha E; Olaso, Danae G; Krischak, Madison K; Reynolds, John M; Haney, John C; Klapper, Jacob A; Hartwig, Matthew G

In the US, an overall national decline in organ transplants has accompanied the substantial burden of COVID-19. Amidst significant regional variations in COVID-19, lung transplantation (LTx) remains a critical life-saving operation. Our LTx practice during the early pandemic may provide a blueprint for managing LTx in an era of continued community prevalence. Patients who underwent LTx at our institution between March 1 and May 20, 2020 were included. Recipient, operative, and donor characteristics were compared to those from our program in 2019, and COVID-19 testing practices were evaluated for March, April, and May to understand how our practice adapted to the pandemic. Our program performed 36 LTx, 33% more than the same period in 2019. Recipient, operative, and donor characteristics during COVID-19 were similar to those in 2019. By April 1, all donors and recipients underwent pre-transplant COVID-19 testing, all returning negative results. To date, no recipients have developed post-transplant COVID-19. At our institution, pre-transplant COVID-19 testing, use of local donor lungs, and avoidance of donors from areas of increased community penetration supported a safe and effective LTx practice during the early COVID-19 pandemic. Continued follow-up is required to ensure the long-term safety of these newly-transplanted patients.