Effect of COVID-19 Pandemic on Complications and Mortality in the Early Postoperative Period After Heart Transplantation

•Successfully implemented adaptation to address challenges posed by staff redeployment, ICU constraints, and hospital resource limitations associated with the pandemic, all while maintaining the continuity of heart transplant activity.•Orthotopic heart transplantation could be safely performed during the COVID-19 pandemic, showcasing the center's resilience and adaptability in navigating unprecedented circumstances.•The safe execution of these procedures underscores the center's commitment to maintaining critical medical interventions amid the challenges posed by the ongoing pandemic. The coronavirus disease 2019 (COVID-19) outbreak directly impacted heart transplantation (HT) surgery activity. Reallocating resources and converting surgical intensive care units to COVID‐19 facilities led to reduced accessibility and quality of health care facilities to heart recipient patients. To study the effect of the COVID-19 pandemic on heart transplantation activity and outcomes in the early postoperative period. Retrospective data analysis of patients undergoing orthotopic heart transplantation in our institution from March 2018 to February 2022. The patient population (N = 281) included 223 (79.4%) men and 58 (20.6%) women. The perioperative data of the prepandemic group, March 2018 to February 2020 (N = 130), and the pandemic group, March 2020 to February 2022 (N = 151), were compared. We found differences in preoperative inotropic support between the groups (N = 43 (33.1%) vs N = 72 (47.7%), P < .05), respectively). The number of urgent HTs increased during the COVID-19 pandemic (N = 51 (39.2%), vs N = 72 (47.7%), P = .155). Analyzed groups did not differ according to renal, pulmonary, or neurology complications. Intensive care unit (ICU) standing time was longer in the pandemic group (6 days [3-12] vs 11 days [5-12], P < .001). We found that during the COVID-19 pandemic, the number of end-stage heart failure recipients requiring cardiac support increased. Extended time of ICU standing in the pandemic group may be related to the COVID-19 pandemic. Although some efforts have been made to reduce the impact of the pandemic, more research is required.