Scientific Session I: Thoracic

Objective: Lung transplantation is used to treat severe pulmonary lymphangioleiomyomatosis (LAM). With the recent introduction of mTOR inhibitors for LAM, which pose a risk for complications like airway dehiscence, an updated evaluation of LAM lung transplant outcomes is needed. Methods: We identified all adult lung transplant recipients 2005-2021 using the SRTR database; recipients were stratified by diagnosis (LAM vs. other). Descriptive statistics were performed. Kaplan-Meier survival curves were compared. Adjusted hazard ratio (aHR) for mortality by LAM diagnosis was calculated, adjusting for baseline recipient and donor characteristics by multivariable Cox regression. Results: 32,337 patients were identified, with 156 (0.5%) diagnosed with LAM. LAM patients were younger and had lower BMI and creatinine ( P < 0.001; TABLE1Table T01-1). LAM patients were 100% female ( P < 0.001). Operative outcomes, including airway dehiscence, did not significantly differ between groups, besides prolonged chest drain use and a trend towards decreased prolonged ventilation in LAM patients (Table T01-1). LAM patients had higher survival at 30 days (99.4% vs. 96.8%), 1 year (94.2% vs. 86.6%), and 15 years (49.8% vs. 18.3%) post-transplant ( P < 0.001; Fig. T01-1). After adjusting for donor and recipient characteristics, LAM diagnosis was associated with 45% lower mortality than other diagnoses