PT - JOURNAL ARTICLE AU - O Deri AU - S Chatterji AU - L Seluk AU - N Furie AU - I Shafran AU - R Mass AU - L Sternik AU - E Raannani AU - R Kremer AU - Y Kassif AU - E Nachum AU - N Zeitlin AU - J Frogel AU - M Saute AU - A Onn AU - A Kogan AU - L Levy TI - When should lung transplant be considered for severe COVID-19 associated ARDS? AID - 10.1183/13993003.congress-2022.4103 DP - 2022 Sep 04 TA - European Respiratory Journal PG - 4103 VI - 60 IP - suppl 66 4099 - http://erj.ersjournals.com/content/60/suppl_66/4103.short 4100 - http://erj.ersjournals.com/content/60/suppl_66/4103.full SO - Eur Respir J2022 Sep 04; 60 AB - Background: COVID-19 can cause severe respiratory failure and acute respiratory distress syndrome (ARDS). Lung transplantation is a potentially lifesaving treatment for patients with COVID-19–associated ARDS, but uncertainty still surrounds patient selection and timing of referral.Study objective: To identify factors associated with recovery (weaning from ECMO and intensive care unit discharge) versus death of patients with covid-19-associated ARDS on Extracorporeal Membrane Oxygenation (ECMO) listed for lung transplantation.Methods: Retrospective review of all consecutive cases referred to our center and listed for lung transplantation between January and December 2021. Factors associated with recovery versus death while on the waitlist were assessed.Results: Sixteen patients were included in the study: 2 underwent a lung transplant, 8 recovered, and 6 died. The median time on the transplant wait list was 20 days. Patients who recovered were significantly younger (47 vs. 58) with a trajectory towards decreased time on ECMO (71.5 vs. 83.5) and a longer time interval between hospital admission and initiation of mechanical ventilation (7 vs. 2.5 days), ECMO (9 vs. 4 days) or listing for transplant (75 vs. 56.5 days).Conclusions: Although the question regarding which of the patients on ECMO due to COVID-19 ARDS needs lung transplant remains unanswered, it appears that younger patients are more likely to recover without transplant even after a prolonged period on ECMO.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 4103.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).