Conclusions: Our results suggest that concentration– controlled EV-CNI based therapy is a safe immunosuppression, which preserves renal function after LUTX. 29 Elevations in Troponin-I (Tn-I) Following Lung Transplantation Predict Survival R. Celis, 2 J.D. Estep, 1 C. Orrego, 1 L. Semones, 1 R. Kasevan, 3 H. Seethamraju, 3 G.P. Noon, 3 M. Loebe, 3 G. Torre. 11 TMH, Houston, TX; 2 UTMH, Galveston, TX; 3 Baylor College of Medicine, Houston, TX. Purpose: Multiple models exist to predict survival following lung trans- plantation; however, the impact of early cardiac dysfunction as determined by elevations in Tn-I has not been evaluated. The objective of this study was to evaluate the prognostic impact of elevations Tn-I in the early post-op period. Methods and Materials: We determine Tn-I in 95 consecutive lung trans- plant recipients (2005-2007). All patients had either normal coronaries or non-obstructive CAD with normal nuclear stress tests and normal LVEF 60%. There were 73 bilateral lung transplants and 18 single lung trans- plants. Results: At the end of f/u (1500 days) 27 pts died and 68 pts were alive. Using a proportional hazards model we determined that Tn-I measured at the time of arrival to the ICU was the best predictor of survival (p=0.0296). Neither Tn-I measurements at other time points nor creatinine were significant. Further, we dichotomized Tn-I values at 7ng/ml. Impor- tantly, the proportion of bilateral lung transplants versus single lung trans- plants was higher in the cTnI 7 group (30/1 versus 43/17). Neither age, ischemic time, LVEF or hemoblogin A1C were different at baseline. Kaplan-Meier survival curves for the two groups were constructed and tested for the difference using a log rank test. As shown in figure, the Tn-I  7 group had better survival compared to the cTNI 7 group, p=0.0223.[figure1] Conclusions: These data demonstrates that cardiac injury as measured by elevations in Tn-I levels in the early post-operative stage have powerful prognostic implications. We suggest that strategies to minimize early myocardial injury may positively impact survival. 30 Enoxaparin for the Treatment of Venous Thromboembolism in Lung Transplant Recipients M.-Y. Huang, 1 C. Hui, 1 L.E. Leard, 2 R.F. Boettger, 1 J.P. Singer. 2 1 University of California, San Francisco, San Francisco, CA; 2 University of California, San Francisco, San Francisco, CA. Purpose: Venous thromboembolism (VTE) is common following lung transplant and enoxaparin is an approved therapy for VTE. The anti-Xa test is an assay for monitoring enoxaparin; elevated anti-Xa levels (AXAL) are associated with increased risk of hemorrhage. We noted a high rate of hemorrhage in patients being treated with enoxaparin and started manda- tory monitoring of AXAL. We sought to elucidate the relationship between enoxaparin dose and AXAL in lung transplant recipients. Methods and Materials: We identified all patients receiving twice-daily dosing of enoxaparin. Standard enoxaparin dosing was defined as 0.9-1.1 mg/kg. After noting a high rate of supratherapeutic AXALs, we imple- mented an initial non-standard dose of 0.8 mg/kg twice daily. AXAL was measured 4 hours after the third dose. The range for therapeutic AXAL is 0.5-1.0 units/mL; supratherapeutic AXAL was defined as 1.0 u/ml. Multivariable linear regression analysis was used to examine the associa- tion between enoxaparin dose and AXAL; age, BMI, serum creatinine, tacrolimus level, liver function, and voriconazole use were included as covariates. Results: In our cohort, (n = 25; mean age 56.310.9 yrs; BMI 26.45.0 kg/m2; serum creatinine 1.10.4 mg/dL) 18 patients received standard and 7 patients received non-standard enoxaparin dosing. There were no signif- icant differences between the two groups. For standard dosing, 12/18 patients had supratherapeutic AXAL (67%; 95% CI 43%-91%) with a mean AXAL of 1.3 u/ml (95% CI 1.06 –1.53). For non-standard dosing (mean 0.8 mg/kg; 95% CI 0.73– 0.88), 0/7 patients had supratherapeutic AXAL (mean 0.81 u/ml; 95% CI 0.67– 0.94). All patients were included in the multivariable linear regression analysis. After controlling for covari- ates, for each 0.1mg/kg increase in enoxaparin, the mean AXAL increased by 0.20 u/mL (95% CI 0.02-0.38; p=0.035). Conclusions: Use of standard dosing of enoxaparin in lung transplant recipients is associated with a high incidence of supratherapeutic AXAL. Consideration should be given to reducing the initial dose of enoxaparin and/or monitoring AXAL. 31 Outcome of Lung Transplant Candidates on Mechanical Ventilation or Extracorporal Support J. Gottlieb, 1 A.R. Simon, 2 J. Hadem, 3 M. Dierich, 1 O. Wiesner, 3 M. Strueber, 2 T. Welte. 11 Hannover Medical School, Hannover, Germany; 2 Hannover Medical School, Hannover, Germany; 3 Hannover Medical School, Hannover, Germany. Comparison of labaratory parameters before and after conversion at switch 12 months post EV p-value Leucocytes (G/l) 6,96 7,88 n.s. Hemoglobin (g/dl) 11,50 11,87 n.s. Thrombocytes (G/l) 238,6 246,2 n.s. Cholersterol (mg/dl) 214,4 246,3 0,025 Triglycerides (mg/dl) 193,7 267,7 0,044 S16 The Journal of Heart and Lung Transplantation, Vol 29, No 2S, February 2010