ObjectiveRacial disparities in organ allocation may result in differential survival for marginalized groups. This study aims to examine the impact of the November 2017 lung allocation policy change (LAPC) on trends and outcomes of Hispanic lung transplant (LT) recipients. MethodsThe United Network for Organ Sharing (UNOS) database was used to identify adult (≥ 18 years old) LT recipients between January 2010 and March 2023. Recipients were categorized into 3 self-identified racial groups (Hispanic, non-Hispanic White, and non-Hispanic other). The Mann-Kendall trend test was used to assess the trend in rates of Hispanic LT over 5 years pre- and 5 years post-LAPC. The primary outcome was one year mortality. ResultsA total of 28,495 recipients from 80 centers were included, with 15,343 (53.8%) pre-policy change and 13,152 (46.2%) post-policy change. The racial distribution of LT recipients was pre-LAPC: [Hispanic: 1,013 (6.6%), White: 12,601 (82.1%), Other: 1,729 (11.3%)] and post-LAPC: [Hispanic: 1,522 (11.6%), White: 9,873 (75.0%), Other: 1,757 (13.4%)] (p<0.001). Between 2013 and 2017, the proportion of Hispanic LT recipients increased from 6.0% to 7.6% (p=0.221). Post-LAPC, the proportion increased from 8.5% in 2018 to 14.4% in 2022 (p<0.027). Unadjusted 1-year survival rates were: pre-LAPC: [Hispanic: 88.8%, White: 87.6%, Other: 86.8%, log-rank p=0.260] and post-LAPC: [Hispanic: 90.6%, White: 88.2%, Other: 86.1%, log-rank p<0.001]. ConclusionsThe LAPC has led to increased access to LT and improved one-year survival rates among Hispanics. However, efforts should continue to address disparities among other racial groups and ensure equitable outcomes for all recipients of LT.