Abstract Background Lung transplantation improves survival and quality of life in patients with advanced lung disease.Shifts in population demographics and the COVID-19 pandemic may have influenced waitlist patterns. We examined temporal trends in U.S. lung transplant waitlist candidates and the impact of COVID-19. Methods We analyzed SRTR and OPTN data (2012-2023). Candidate characteristics included age, sex, race, primary lung disease,lung allocation score (LAS), and blood type. Pre-COVID (2016-2019) was compared with post-COVID (2020-2023). Results A total of 51,350 candidates were evaluated. Annual new listings increased by 45.7% and total waitlist size by 9.3% from 2012-2023. COVID led to a 16.9% decline in new listings in 2020 and lower post-COVID waitlist candidates vs. pre-COVID (4207.5 vs. 4505, p 0.05). Most candidates were aged 50-64 years (46.7%), with the greatest growth seen in 65 + years (+61.1%). Female representation declined post-COVID (45.6% vs. 48.6%, p 0.005). White candidates remained the majority (75.5%) but declined (-14.6%) as Hispanic (+124.1%) and Asian (+102.8%) representation rose. Restrictive lung disease predominated (56.4%) and increased, while obstructive lung disease declined. More candidates were transplanted within 90 days post-COVID (61.2% vs. 50.5%, p 0.005). LAS and blood type distributions remained stable. Conclusion Over the past decade, lung transplant waitlist demographics have shifted toward older age, greater racial/ethnic diversity, and shorter wait times post-COVID. These trends highlight evolving referral patterns and underscore the need for research COVID’s impact on lung transplant waitlist This abstract is funded by: None
O Tripathi (Fri,) studied this question.