Purpose: Increasingly frequent, extracorporeal membrane oxygenation (ECMO) or extracorporeal lung assist (ECLA) is temporary used as a bridge to lung transplantation (LTX). This study was designed to compare survival after LTX in patients requiring ECMO with that of patients not pre-op supported by ECMO. Methods and Materials: From 2002 to 2011 137 patients underwent LTX. 53% of patients presented with idiopathic pulmonary fibrosis and markedly elevated pulmonary artery pressure (70%). Results: 14 patients required pre LTX ECMO or ECLA support (age 40.3 14 years, double-LTX 85.7%, female gender 57%) compared to 123 patients without pre LTX ECMO or ECLA use (age 53.1 12 years, double-LTX 51%, female gender 40.7%). Two patients from this 14 pa- tients supported by ECMO or ECLA died before the LTX. One patient supported by ECLA was weaned from this support and successfully trans- planted. Five additional patients were intra-operatively ECMO supported, and in six of these patients ECMO use was directly extended into the post-operative period. Nine patients required early (7 days) post-opera- tively ECMO support primarily for severe graft dysfunction. Seven patients underwent delayed ECMO support for rejection. The short-term and mid- term survival was not significantly reduced in pre LTX ECMO / ECLA patients (LogRank p=0.28). The 30-day, 90-day and 1-year survival was 87.7%, 80.3% and 73.2% in the patients without ECMO, compared to 83.3%, 66.7% and 66.7% in the pre LTx ECMO /ECLA patients. Conclusions: ECMO-supported patients represent the very sickest patient group of an already existing high-risk population with end-stage pulmo- nary disease. Although survival after LTX is not significantly reduced when pre LTX ECMO / ECLA use is necessary. 705 Pre-Operative Cardiac Variables and Clinical Outcomes in Patients with Bilateral Lung Transplants A. Yadlapati, 1 J. Aboulhosn, 1 J. Belpario, 2 D. Ross, 2 A. Ardehali, 3 R. Saggar. 21 Cardiology, UCLA, Los Angeles, CA; 2 Pulmonary, UCLA, Los Angeles, CA; 3 CT Surgery, UCLA, Los Angeles, CA. Purpose: The aim of this study was to evaluate the relationships between pre-operative cardiac variables and clinical outcomes in patients with bilateral lung transplants. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation, how- ever, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function. Methods and Materials: We reviewed the characteristics of 111 patients who underwent bilateral lung transplant at UCLA from 2002-09 in order to evaluate the prognostic significance of preoperative markers of diastolic function, including: Invasively measured pulmonary capillary wedge pres- sure (PCWP) and echocardiographic variables including mitral A/E1, E/E’13 and A’E’. Results: Out of 111 patients, 62 were male (56%) and average age was 54.0 (SD = 10.5) years. Clinical end-points included: All-cause mortality post-transplant, cardiac death post-transplant, length of hospitalization post-transplant, and evidence of graft dysfunction. Mildly elevated pre- transplant PCWP (16-20 mmHg) and moderate/severely elevated PCWP (20 mmHg) were not associated with adverse clinical events post-trans- plant (p=0.51 and 0.61, respectively). Traditional echocardiographic dopp- ler variables of abnormal diastolic function, including A’E’ and A/E ratio1 did not predict adverse events. An echocardiographic marker of elevated left atrial pressure (E/E’13) also did not predict adverse post- transplant events. Conclusions: Pre-lung transplant invasive and echocardiographic findings of elevated left atrial pressure and abnormal left ventricular diastolic function do not predict adverse post-transplant clinical events. 706 100% 3-Year Survival after Extracorporeal Membrane Oxygenation (ECMO) Bridge to Lung Transplantation (N10) M.B. Connellan, 1 Y. Orr, 1 R. Pye, 2 E. Granger, 1 K. Dhital, 1 C. Soto, 1 M.A. Malouf, 1 P. Spratt, 1 A.R. Glanville, 1 P. Jansz. 11 Cardiopulmonary Transplant Unit, St. Vincent’s Hospital, Sydney, NSW, Australia; 2 Department of Anaesthetics and Intensive Care, St. Vincent’s Hospital, Sydney, NSW, Australia. Purpose: Despite early concerns regarding a prohibitive mortality rate, patients with severe respiratory failure needing EMCO are now evaluated on a case by case basis for consideration of lung transplantation (LTX). We have reported success with our initial 3 cases. In this report we review our experience of 10 consecutive cases of ECMO bridge to LTX and examine perioperative outcomes, complications and survival. Methods and Materials: 34 patients required ECMO salvage for severe respiratory failure June 2002-September 2011. 12/34 in whom the pulmo- nary disease process was deemed irrecoverable were listed for LTX. Indications were cystic fibrosis (n=5), pulmonary fibrosis (n=3) and post infective diffuse alveolar damage (n=4). One died from sepsis prior to LTX and one recovered without LTX. The LTX group (M:F=4:6), mean age of 23 years (range 12-46 years) were transplanted after a mean of 23 days (range 10-58 days) ECMO. Two patients were transplanted off site, the unit having had no ECMO transport capability at the time. Results: All ten LTX patients survive: mean follow-up of 3.2 years (range 0.1 - 9 years). Mean hospital stay was 66 days (range 38-104 days) with a post transplant mean ventilation time of 23 days (range 4-47 days); 3 required continuation of ECMO post transplant, 5 thoracotomy for post- operative bleeding, 7 tracheotomy to facilitate weaning from ventilation and 4 temporary renal replacement therapy. One patient developed a bronchial anastomotic stricture requiring endobronchial intervention. Two were re-transplanted (48 and 71 months) for bronchiolitis obliterans syn- drome. Conclusions: Despite prolonged hospitalisation and significant morbidity associated with LTX, patients with single organ dysfunction requiring ECMO bridge to lung transplantation can be transplanted successfully with an acceptable medium term survival. 707 Pre-Transplant Allosensitization Increases Time to Transplant and Waitlist Mortality in Lung Transplantation H. Qureshi, 1 H. Seethamraju, 2 M. Loebe, 2 S. Scheinin, 2 B. Bruckner, 2 S. LaFrancesca, 2 S. Jyothula, 2 A.D. Parulekar. 11 Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX; 2 Methodist J.C. Walter Jr. Transplant Center, The Methodist Hospital, Houston, TX. Purpose: In order to determine the effect of allosensitization as a barrier to lung transplantation, we evaluated the impact of elevated panel reactive antibody [(PRA) 25%] on waitlist time, likelihood of transplantation, and waitlist mortality. Methods and Materials: We performed a retrospective cohort study of 340 consecutive patients listed active for lung transplant between 1/1/2007 and 12/31/2010 at The Methodist Hospital. Patients were prospectively screened for anti-HLA antibodies prior to listing for transplant and PRA S242 The Journal of Heart and Lung Transplantation, Vol 31, No 4S, April 2012