Purpose: Chronic lung allograft dysfunction(CLAD) is the barrier to improve long term outcome of lung transplantation. This study aims to examine prevalence and characteristics of patients with CLAD who were listed for lung re-transplant. Methods: This is a retrospective observational study. Adult patients (>18 YO) listed for lung re-transplant due to bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome(RAS) were identified from SRTR database. Numerical data were reported in mean and standard deviation. Categorical data were reported in count and percent. T-test and Chi-square test were performed to compare 2 groups. Results: 1546 adult CLAD patients were included. 85.51% of these patients have BOS phenotype. Mean age was 42.79. There was no significant difference in age, mPAP, history of smoking, previous malignancy, or pan-resistant infection between BOS and RAS groups. Oxygen requirement at listing time was significantly higher in RAS group (5.64 §6.33 vs 2.93 §3.31, p < 0.01). Proportion of patients who were on ECMO at listing time is significantly higher in RAS group (4.02% vs 0.91%, p<0.01). LAS of RAS group was significantly higher(52.07 §18.71 vs 43.60 § 17.71, p < 0.01). 67.86% of RAS group received re-transplant compared to 59.15% of BOS group (p = 0.014).

Background Optimising outcomes for critically ill patients with COVID-19 patients requires early interdisciplinary rehabilitation. As admission numbers soared through the pandemic, the redeployed workforce needed rapid, effective training to deliver these rehabilitation interventions. Methods The COVID-19 ICU Remote-Learning Rehab Course (CIRLC-rehab) is a one-day interdisciplinary course developed after the success of CIRLC-acute. The aim of CIRLC-rehab was to rapidly train healthcare professionals to deliver physical, nutritional and psychological rehabilitation strategies in the ICU/acute setting. The course used blended learning with interactive tutorials delivered by shielding critical care professionals. CIRLC-rehab was evaluated through a mixed-methods approach, including questionnaires, and follow-up semi-structured interviews to evaluate perceived impact on clinical practice. Quantitative data are reported as n (%) and means (SD). Inductive descriptive thematic analysis with methodological triangulation was used to analyse the qualitative data from the questionnaires and interviews. Results 805 candidates completed CIRLC-rehab. 627 (78.8%) completed the post-course questionnaire. 95% ( n = 596) found CIRLC-rehab extremely or very useful and 96.0% ( n = 602) said they were very likely to recommend the course to colleagues. Overall confidence rose from 2.78/5 to 4.14/5. The course promoted holistic and humanised care, facilitated informal networks, promoted interdisciplinary working and equipped the candidates with practical rehabilitation strategies that they implemented into clinical practice. Conclusion This pragmatic solution to educating redeployed staff during a pandemic increased candidates’ confidence in the rehabilitation of critically ill patients. There was also evidence of modifications to clinical care utilising learning from the course that subjectively facilitated holistic and humanised rehabilitation, combined with the importance of recognising the humanity, of those working in ICU settings themselves. Whilst these data are self-reported, we believe that this work demonstrates the real-term benefits of remote, scalable and rapid educational delivery.

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