high in lung transplanted patients. As expected, the alterations involve both LES tone and esophageal peristalsis. In our series, a high prevalence of hyperkinetic motor disorders was evident and, in particular, of SED, a condition caused by nitrergic pathway impairment. Further studies are needed to ascertain the causative factor for this abnormality. 730 Early Major Neurologic Complications after Lung Transplantation: Prevalence, Risk Factors and Outcome N. Shigemura, 1 J. Bhama, 1 K. Fujimoto, 1 A. Shiose, 1 A. Ali, 1 H. Kanemitsu, 1 C. Gries, 2 M. Crespo, 2 B. Johnson, 2 J. Pilewski, 2 C. Bermudez. 11 Cardiothoracic Surgery, Division of Cardiothoracic Transplant, University of Pittsburgh Medical Center, Pittsburgh, PA; 2 Medicine, Division of Pulmonary Allergy and Critical Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. Purpose: Early major neurologic complications following lung transplan- tation represents a major source of morbidity for patients and compromises their quality of life; however, their full spectrum as well as the impact on outcomes in lung transplantation remain unknown. Methods and Materials: Patients transplanted at our institution between 2004 and 2010 were identified (n=759). Data on the complications occur- rence, timing, management and outcome were extracted from our trans- plant database and medical record review. Results: 70 patients (9.2%) experienced a wide spectra of major neuro- logic complications within 30 days following lung transplantation. Major neurologic complications were defined as those that were potentially life- threatening or required urgent treatment/intubation or admission to the intensive care unit. Most common complications were stroke (28%) and severe toxic/metabolic encephalopathy (21%). Of note, four patients (5%) developed severe hyperammonemia and three of them died despite of all aggressive multidisciplinary management. Multivariate analysis demon- strated advanced age, high body mass index (30), history of coronary artery disease and use of cardiopulmonary bypass increased the risk for early major neurologic complications (p0.05), whereas lung allocation score and underlying lung disease did not. There was a significant differ- ence in in-house mortality as well as long-term survival between the patients with neurologic complications and without (90-day mortality: 15% in neurologic complications group versus 4%, p=0.03). Conclusions: Early major neurologic complications after lung transplan- tation are common and it carries substantial morbidity and mortality. The etiology for its development are multi-factorial; however, given the risk factors identified in this study, additional pre-transplant work-up, intra- and post-operative monitoring for high-risk patients may help reduce the inci- dences. 731 Acoustic Analysis of a Mechanical Circulatory Support L. Hubbert, B. Peterzén, H. Granfeldt, H. Ahn. Heart Centre, University Hospital, Departments of Medicine & Health at Linkoping University, Linkoping, Sweden. Purpose: An experimental model to describe the frequency analysis pat- tern of the Heart-Mate™ (HMII) under different conditions. Results gave reference frequency patterns incorporated into the ongoing SoundMate study. Methods and Materials: A heart-lung-machine was connected to a HMII in a closed circuit with pulsatile flow of 4 L/min.The HMII was placed in a plastic bag filled with water to allow sound recordings via a smartphone. Baseline measurements were recorded without any obstruction of the circuit flow. Thereafter the pump outflow tubing was narrowed to mimic increased afterload at various pump speeds. Results: A normal frequency analysis pattern was seen at all pump speeds as is the case for devices in situ. (fig 1). When afterload was increased the frequency pattern became broader with a more extensive high frequency spectrum. Fig 1. Frequency pattern from a patient included in the SoundMate study (1), in the experimental model at normal flow (2) and at increased afterload (3). Frequency (x-axis) in Hz amplitude (y-axis) in – dB. Fig 2. Combined frequency analysis curves at different pump speeds, blue; normal flow (n=4), red; increased afterload (n=10). Conclusions: It was possible to detect HMII frequency patterns with mod- ern telecom techniques in the experimental setting. The frequency analysis pattern following an increase in afterload was similar to that previously noticed in humans and may provides a new way of detecting pump thrombosis at an early stage. 732 Preoperative Hypoalbuminemia Predicts Poor Prognosis in Patients Undergoing Left Ventricular Assist Device Implantation T.S. Kato, 1 Y. Kawano, 1 J. Yang, 2 H. Akashi, 2 H. Takayama, 2 Y. Naka, 2 M. Farr, 1 D. Mancini, 1 P.C. Schulze. 11 Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY; 2 Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, NY. Purpose: Several previous studies have described the association between hypoalbuminemia and poor prognosis in patients with advanced heart failure. However, preoperative hypoalbuminemia and post-operative out- come in patients undergoing left ventricular assist device (LVAD) has not been fully elucidated. Methods and Materials: We analyzed 272 consecutive patients who un- derwent elective LVAD implantation as a bridge-to-transplantation at Co- lumbia University Medical Center between 1999 and 2010. Event-free- survival after LVAD implantation was compared between those with hypoalbuminemia (defined as 3.5mg/dL) and those without hypoalbu- minemia. Results: Among the patients studied, 143 patients (52.6%) had pre-oper- ative hypoalbuminemia. Kaplan-Meier analysis and log-rank testing re- S250 The Journal of Heart and Lung Transplantation, Vol 31, No 4S, April 2012