Background and Aims: DAAs allowed reduction of HCV-related liver graft failure. Improvement in metabolic profile was reported during a short 48 weeks observation period after SVR. To evaluate, in LT patients (Pts), the impact of SVR on metabolism, renal and liver function and on arterial hypertension during 3 years of follow up (FU). Method: Assessment of metabolic, kidney and liver function changes, as well as antihypertensive drug modifications, were collected up to 3 years of FU after completion of DAAs therapy. Mean differences were calculated with Anova test and linear regression for continues variables and Fisher’ exact test for categorized variable. Results: 152 LT Pts; all but 6 (n=152, 96%) showed SVR. Pts : males 84%; age: median 63 yrs (IQR 57–70); baseline MELD 9, (IQR 7–12); cirrhosis 26%; HCC diagnosis 36%; SVR was associated with a decrease in fasting glucose in pts without overt diabetes, with a statistical significance at 3 yr vs. baseline -5.5 mg/dl ±22 ( p < 0.004). In diabetic pts, mean fasting glucose level showed a trend to decline. Dyslipidemia prevalence increased over time, with a 12.6% incidence (33.3% at 3 yr vs. 20.7% at baseline), as well as BMI (+2.6 at 3 yr ±9; p = 0.003). An improvement in liver function was recorded at 1 yr and 3 yr as expressed by bilirubin decrease (mean -0.12 mg/dl ±0.7 [p < 0.05] and -0.78 mg/dl ±1.0, respectively [p < 0.001]) and albumin increased concentrations (+0.14 g/l at 3 yr. ±0.5; p = 0.01). MELD score decreased over time -1.26 at 3 yr; p < 0.001). As expected the through serum level of immunosuppressive drugs declined over time (p < 0.0001 at 3 yr) showing strong correlation (p < 0.001) with creatinine level, and borderline ( p = 0.056) with glucose level. Moreover, creatinine showed a significant mean increase after SVR (1 yr vs. baseline 0.06 mg/dl ±0.2; 3 yr vs. baseline 0.08 mg/dl ±0.3 (p< 0.001). Kidney function deteriorated over time with 34.5% of Pts on CKD ≤3 at 3 yr vs. 24.8% at baseline (p < 0.001). Incidence of arterial hypertension was 4.0% at 1 yr and 8.5% at 3 yr compared to baseline (p < 0.001), potential expression of the long interval between LT and DAAs therapy (mean 73 months, IQR 22–131) and of preexisting renal and vascular involvement. Conclusion: elimination of HCV in LTcould have a beneficial impact on glucose metabolism but does not improve lipid profile or reno- vascular complications, which are possibly associated to the long- term exposure to immunosuppressive drugs. THU280 Prospective multicenter study of sofosbuvir-velpatasvir (SOF/VEL) in hepatitis C virus (HCV) negative liver (LT) and kidney transplant (KT) recipients receiving HCV viremic donors Raymond Rubin 1 , David Victor 2 , James Burton 3 , Elizabeth Verna 4 , James F. Trotter 5 , Claus Niemann 6 , Constance Mobley 2 , Norah Terrault 7,8 . 1 Piedmont Hospital; 2 Houston Methodist Hospital; 3 University of Colorado; 4 Columbia University; 5 Baylor University; 6 UCSF; 7 University of Southern Californai; 8 Keck Medicine at USC Email: terrault@usc.edu Background and Aims: A greater pool of HCV-viremic donors has led to expanded use of these organs in transplant recipients without HCV infection with the goal of reducing wait-list morbidity and mortality. The optimal treatment strategy is unclear, in terms of best DAA option, timing of initiation and duration of therapy. We sought to evaluate the safety and efficacy of SOF/VEL for 12 weeks among HCV- negative LT and KT recipients. Method: 6 U.S. transplant programs prospectively enrolled adults listed for primary LT or KT with the following exclusions: re- transplant, HBV or HIV infection, multiorgan (except SLK). Donor exclusions were >F1 for LT and kidney donor profile index >85% for KT. SOF/VEL was started once viremiawas confirmed post-transplant and patient judged to be clinically stable. The primary endpoints were SVR12 and safety. Results: Of 115 patients consented, 23 were transplanted (12 liver, 11 kidney) of whom 22 became viremic post-transplant. Recipients had mean age 54 yrs, 57% male; donors’ mean was 38 years, 78% male, with 74% with confirmed brain death. HCV genotypes were 57% GT1, 26%GT2, 4%GT3 and remainder not determined. Median log HCV RNA on day 3 was 6.45 (range 1.2–8) in LTand 3.59 (range 1.3–4.7) in KT; the kinetics of HCV RNA decline are shown inTable. All reaching the SVR12 timepoint are HCV negative (13/13), including 2 with detectable HCV RNA at end of treatment. Serious adverse events considered to be possibly related include: 1 antibody-mediated rejection (in A2 to O LT recipient) and 1 progressive biliary sclerosis of indeterminant etiology after LT. Delays in treatment initiation (n=5 beyond day 21) were related to delayed renal recovery (n = 3), administration of amiodarone (n = 1) and provider preference (n = 1). Conclusion: SOF/VEL for 12 weeks was highly effective therapy for HCV-negative liver and kidney transplant recipients who received HCV-viremic donors. All transmitted infections (22/23) were detect- able by day 3, with different viral kinetics in KT versus LT, supporting early initiation of antiviral therapy. Safety was excellent but vigilance of immune-mediated complications is warranted. THU281 Incidence and prognostic impact of cancer after liver transplantation Manuel Rodríguez-Perálvarez 1 , Gonzalo Crespo 2 , Tommaso Di Maira 3 , Patricia Salvador 4 , Sheila Pereira 5 , Ainhoa Fernandez 6 , Trinidad Serrano 7 , Jose Ignacio Herrero 8 , Rocio González-Grande 9 , Maria Angeles Lopez Garrido 10 , Ruben Ciria 1 , Carmen Bernal 5 , Aránzazu Caballero-Marcos 6 , Sara Llorente Perez 7 , Jordi Colmenero 2 , Maria Senosiáin 4 , Flor Nogueras López 10 , Susana Lopez Ortega 9 , Mercedes Iñarrairaegui 8 , Victoria Aguilera Sancho 3 , Andres Valdivieso Lopez 8 , María Dolores Espinosa Aguilar 10 , Cristina Borao 7 , Miguel Jiménez 9 , Jesús Rivera 2 , Magdalena Salcedo 6 , Fernando Rotellar 8 , Manuel De La Mata Garcia 1 , Mikel Gastaca 4 , Miguel Navasa 2 , Marina Berenguer Haym 3 , Miguel Angel Gómez-Bravo 5 . 1 Reina Sofía University Hospital, IMIBIC, Figure: (abstract: THU280) POSTER PRESENTATIONS S276 Journal of Hepatology 2020 vol. 73 | S123–S400