(group III). Results: Of 40,326 analyzed LT (9495, 5448, and 25,383 in groups I-III respectively), about 5.8% (N=2319) received SLK (6, 9, and 5% in groups I-III respectively). Of LTA, 22%, 14%, and 64% were performed for group I-III respectively. Similar respective figures of all SLK were 23, 20, and 57% respectively (Figure). Frequency of SLK increased from about 4% in 2002 to about 7% in 2011. Trends for group I-III were 4 to 5.8%, 4 to 10%, and 4 to 8% respectively. SLK for NASH+CC (group II, n=477) compared to1842 non-NASH SLK (group II+III) were older, more likely to be females, diabetics, and Caucasians, and have higher body mass index. Five year respective outcomes after SLK comparing group I-III were 78 vs. 76 vs. 66% for liver graft, 79 vs. 72 vs. 65% for kidney graft, and 81 vs. 77 vs. 69% for patient survival, Log Rank P<0.0001 for all. Comparing groups I and II, outcomes were similar for liver graft (P=0.29) and patient survival (p=0.14) but worse for group II on kidney graft (P=0.01). Diabetics compared to non-diabetics had worse five year kidney survival for non-NASH SLK (67 vs. 71%, P=0.044). Similar respective figures among group II were 69 vs. 78%, P=0.017. Patients receiving SLK for NASH or CC (group II) were 29% more likely to lose kidney graft [1.29 (1.002-1.67]) compared to non-NASH transplants after controlling for recipient characteristics and kidney donor risk index. Other strong predictors were black race [1.32 (1.06-1.63] and dialysis [1.26 (1.07-1.49)]. Conclusion: Frequency of SLK transplants is increasing among NASH patients requiring liver transplanta- tion. SLK recipients for NASH have worse renal outcomes independent of associated diabetes. Studies are needed to examine mechanisms of renal pathology in NASH and to develop strategies to improve renal outcomes in NASH patients receiving SLK. Su1013 Prevalence and Outcomes of Incidental Hepatocellular Carcinoma Among Liver Transplant Recipients: A Study From United Nation of Organ Sharing (UNOS) Database Wuttiporn Manatsathit, Thoetchai Peeraphatdit, Wikrom Chaiwatcharayut, Monil H. Patel, Supakanya Wongrakpanich, Surakit Pungpapong, Eyob Feyssa Background: The prevalence and tumor characteristics of incidental hepatocellular carcinoma (iHCC) identified at orthotropic liver transplantation (OLT) and post-OLT outcomes have been reported in several small studies with conflicting conclusions. In this study, we utilized UNOS database to explore the prevalence of iHCC among cirrhotic patients who underwent OLT and compared outcomes and tumor characteristics in explanted liver of patients with iHCC and previously known HCC (pkHCC). Methods: Utilizing UNOS database, cirrhotic patients who underwent OLT from February 27, 2002 to June 2, 2014 were identified. Patients <18 years old, underwent repeat OLT, and with conflicting data in the diagnosis or explant pathology were excluded from the analysis. Recipient demographics (age, race, and gender), liver disease characteristics (MELD score, diagnosis of HCC, etiology of cirrhosis, and time on waiting list) and tumor characteristics in explanted liver were compared between iHCC and pkHCC groups. Kaplan-Meier curves for survival between patients without HCC (non-HCC), iHCC, and pkHCC were performed. Multivariate Cox regression analysis adjusted for potential confounder was used Results: During the study period, of 56,191 adult cirrhotic patients who underwent OLT, iHCC were reported in 1,720 patients (prevalence of 0.04%). Demographic data, MELD, days on waiting list, and etiology of liver disease are shown in table 1. 5-year survival was similar between iHCC and pkHCC groups, but both were significantly lower than non-HCC group. (Figure 1) During median follow up time of 3.5 [1.3, 6.3] years, there was 9.3, 8.2, and 5.3 death per 100 person-year in iHCC, pkHCC, and non-HCC groups (p<0.0001). In comparison to non-HCC group, iHCC and pkHCC were equally associated with a 1.27-fold increase in all-cause mortality, (95% CI, 1.15-1.42 and 1.21-1.34, respectively). Based on available explant data collected since 2012, tumor characteristic was similar between iHCC and pkHCC groups in particular differentiation grade, numbers, sizes, and lymphovascular invasion. Interestingly, 31% and 21% of patients with iHCC had tumor burden beyond Milan and UCSF criteria while 29% and 18% of patients with pkHCC had tumor beyond Milan and UCSF criteria. Conclusion: Our study demonstrated that iHCC is generally uncommon among cirrhotic patients who underwent OLT (prevalence of 0.04%). Recipient survival and HCC recurrence rate after OLT of patients with iHCC was similar to patients with pkHCC. This can be explained by comparable tumor characteristics between the two groups. Significant number of patients with iHCC also had tumor burden beyond Milan and UCSF criteria, similar to pkHCC. S-1037 AASLD Abstracts Table 1:Demographic, MELD, days on waiting list, and etiology of cirrhosis of patients with iHCC and pkHCC * p-value < 0.001 Figure 1: Kaplan-Meier curves of patients with iHCC, pkHCC, and non-HCC (P-value 0.128 between iHCC and pkHCC) Su1014 The Association Between Pre-Orthotopic Liver Transplant Transthoracic Echocardiogram Findings and 6 Month Post-Transplant Outcomes: A Case- Control Analysis Monica Konerman, Jennifer Price, Catherine Campbell, Swathi Eluri, Ahmet Gurakar, James P. Hamilton, Zhiping Li Background: The optimal evaluation for cardiopulmonary risk stratification of liver transplant (LT) candidates has not been well established, particularly for non-ischemic processes. Transthoracic echocardiography (TTE) has been the primary modality to assess global cardiac function prior to LT. The aim of this study was to evaluate the association between pre-LT TTE findings and 6 month post-LT outcomes. Methods: This is a retrospective analysis of adults who underwent LT from 2000-2011. Patients without a pre-LT TTE or who underwent multiple LT's were excluded. Patients who died within 6 months of LT were cases, and age- and gender-matched patients who survived >6 months post-LT were selected as controls. Cases were further categorized by cause of death as either a primary cardiopulmonary (CP) process (n=20) or non-CP process (n=18). A CP cause of death was defined as cardiac arrest, cardiogenic shock, congestive heart failure, myocardial infarction, arrhythmia, respiratory failure, or massive pulmonary embolism. A single cardiologist blinded to clinical data also re-analyzed TTEs for all cases. Demographic, clinical characteristics, and pre-LT TTE data were analyzed using logistic regression adjusted for clustering by matching. Survival analysis was performed using Kaplan Meier curves. Results: There was a higher odds of death within 6 months of LT with ≥mild mitral regurgitation (MR) (OR 3.44, p=0.03) or an incomplete assessment of right ventricular systolic function (RVSF) (OR 24, p=0.004) (Table 1). This is further demonstrated in the Kaplan Meir curves (Figure 1; p= 0.03 MR; p= <0.0001 missing RVSF). These findings persisted when comparing patients with CP cause of death to controls, but not when comparing non-CP to controls. Among patients who died post- LT, those who died from a CP cause were older as compared to those who died of a non- CP cause (61 vs 54.5, p= 0.04), had longer intervals between TTE and LT (122 vs 29 days, p= 0.05), and had less complete assessments of RVSF (p=0.009). Compared to non-CP death cases, CP death cases also had lower RV fractional area change (p=0.04) and RV visualization insufficient to estimate triscupid annular plane systolic excursion (TAPSE) (p= 0.05). Conclusions: In this retrospective case-control analysis of LT patients, multiple TTE parameters were associated with patients who died within 6 months of LT, and in particular patients with a CP cause of death. Overall, patients who died within 6 months of LT were AASLD Abstracts