Abstract Rationale Until recently Cystic Fibrosis (CF) was the 3rd commonest cause for lung transplantation worldwide and the most common cause in people under 50 years of age. However, with the advent of highly effective modulator therapies (HEMT) starting with Ivacaftor (licensed in 2013) and later with elexacaftor-tezacaftor-ivacaftior (ETI, licensed in 2020), it was hoped that the number of CF transplants would decrease. Methods We evaluated all lung transplants in the Irish National Lung and Heart Transplant program Mater Misericordiae University Hospital (MMUH), Dublin since its inception in 2005 with specific reference to transplants in PWCF. All referrals to this programme were in accordance with International Society for Heart and Lung Transplantation (ISHLT) lung transplant guidelines Results From 2005 to 2013 (no HEMT), 83 lung transplants were performed 17 of which were in PWCF. Between 2013 and 2020 (ivacaftor alone), 204 transplants were performed 58 were in PWCF. Between 2020 and 2025 (to date, ETI) 100 transplants were performed, only 4 of which were in PWCF. Over the 3 time periods studied, the ratio of non-CF transplants to CF transplants went from 4.8 (pre HEMT) to 3.5 (ivacaftor alone) to 25 (ETI). There is significant reduction following the introduction of ETI (p 0.001). This reduction reflects the change in clinical status seen in PWCF on ETI referred for transplant, characterized by improved pulmonary, function (p 0.0001), BMI (p = 0.0001) and exacerbation rate (p 0.0001) lifting them out of the transplantation zone Conclusion There is a significant reduction in lung transplants in PWCF following the introduction of ETI due to improvement in clinical status This abstract is funded by: None
McElvaney et al. (Fri,) studied this question.