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Most lung transplant (LTx) recipients recover sufficient functional status to resume working, yet unemployment is common after LTx. Weak local labor markets may limit employment opportunities for LTx recipients.

United Network for Organ Sharing data on first-time LTx recipients 18–60 years old who underwent transplant between 2010 and 2014 were linked to American Community Survey data on unemployment rates at the ZIP Code level. Multivariable competing-risks regression modeled the influence of dichotomous (≥8%) and continuous local unemployment rates on employment after LTx, accounting for the competing risk of mortality. For comparison, analyses were duplicated in a cohort of heart transplant (HTx) recipients who underwent transplant during the same period.

The analysis included 3,897 LTx and 5,577 HTx recipients. Work after LTx was reported by 300 (16.3 …