(1068) Successful Lung Re-Transplantation with Perioperative Desensitization for Sensitized Recipient with Donor Specific DQ Antibody

Purpose: Our center's experience has demonstrated that donation after circulatory (DCD) heart transplantation (HT) safely increases HT activity.At our institution, a greater proportion of recipients were outpatient with lower UNOS status.The aim of this study is to compare intensive care unit (ICU) and hospital length of stay (LOS) between adult DCD and DBD heart transplant recipients and consider the effect of DCD HT on 30-day hospital readmission rates.Methods: A single-center retrospective analysis of DBD vs DCD heart transplants was performed.We compared baseline characteristics between DBD and DCD groups.Outcomes included ICU and hospital LOS, and 30-day hospital readmission rates.We also compared the relative costs and any potential savings associated with implementing a DCD HT program.Results: Between 9/2019-10/2022, a total of 237 patients were included in the analysis: 169 DBD patients (71%), and 68 DCD patients (29%).Baseline characteristics were similar between groups, but UNOS status was significantly lower in the DCD group.ICU LOS (5 (4-7) v 4 (3-6), p=0.021) and total hospital LOS (18 (13-28) v 15 (12-20.5),p=0.0065) were found to be significantly lower in the DCD group.Additionally, the rate of 30day hospital readmissions has decreased significantly following the inception of our DCD HT program and remains well below our institutional goal.Initial analysis of associated costs suggests net savings.Conclusion: In this comparison of DBD versus DCD HT, we identified a significant reduction in both ICU and hospital LOS in the DCD group.We also identified a significant reduction in our 30-day hospital readmission rate following the implementation of our DCD HT program.It is likely that these differences are driven by the lower UNOS status associated with the DCD HT cohort.In spite of additional costs associated with implementing a DCD HT program, it is possible to realize net savings due to lower ICU LOS, hospital LOS, and a lower readmission rate.