296 The Effect of Center Volume on Early Post Lung Transplantation Survival among Patients with Cystic Fibrosis C.A. Merlo 1 , E.S. Weiss 2 , A.S. Shah 21 Johns Hopkins University School of Medicine, Baltimore, MD; 2 Johns Hopkins University School of Medicine, Baltimore, MD Purpose: Caseload is associated with improved patient outcomes for many surgical procedures. Cystic ﬁbrosis (CF) is a multi-system disease with unique post-operative challenges, and little is known about the effect of center experience on post-transplant CF out- comes. The purpose of this study is to determine whether center volume affects survival after lung transplantation in CF. Methods and Materials: All patients in the UNOS Registry with CF undergoing lung transplantation from 2005 through 2007 were included in the study. Low volume centers were deﬁned as those in the bottom 25% while high volume centers were in the top 75% of US centers. A time-to-event analysis was performed using Kaplan-Meier survival and Cox proportional hazards models. Results: There were 601 patients transplanted for CF during the study period. Median (IQR) follow-up time for the cohort was 371 (183-702) days. Mean (SD) age was 28.9 (10.6) years and 48% were female. Mean (SD) FEV 1 % predicted was 27.1 (16.1) and mean BMI (SD) was 19.4 (7.4) kg/m 2 . There were no differences in age, sex, bmi, FEV 1 , oxygen requirements, diabetes, ventilator usage, hemody- namics, and lung allocation scores among patients in high and low volume centers. Patients with CF transplanted at high volume centers had reduced hospital LOS (20.6 days vs. 26.9 days; p0.0001) when compared to those transplanted at low volume centers. 90-day (96% vs. 90%; p=0.004) and one-year (87% vs. 83%; p=0.03) survival were both signiﬁcantly better in the high volume centers. Patients with CF transplanted at high volume centers were also found to have an overall reduced risk of death (HR: 0.65; p=0.03) when compared to those transplanted at low volume centers. Conclusions: High center volume is associated with reduced mor- tality after lung transplantation in CF. Patients with CF transplanted at low volume centers are at risk for worse outcomes post lung transplantation highlighting the need to identify clinical factors and practice patterns associated with improved delivery of care. 297 Incidences of Incisional Complications after De Novo Cardiac Transplantation in AZA-, MMF- or Everolimus-Based Regimens: A Cross-Study Analysis on 1008 Patients A. Zuckermann, J. Kobashigawa, J.M. Arizon, S.-S. Wang, M. Vigano, H. Lehmkuhl, H. Ross, G. Dong, H. Eisen Univ.-Klinik fu ¨r Chirurgie, Vienna, Austria; The David Geffen School of Medicine at UCLA, Los Angeles; Hospital Universitario Reina Sofı ´a, Co ´rdoba, Spain; National Taiwan University Hospital, Taipei, Taiwan; Policlinico S. Matteo, IRCCS Universita ` degli Studi di Pavia, Pavia, Italy; Deutsches Herzzentrum Berlin, Berlin, Germany; University Health Network, Toronto, Canada; Novartis Pharmaceuticals Corporation, East Hanover; Drexel University College of Medicine, Philadelphia Purpose: Proliferation signal inhibitors (PSI) display potent immuno- suppressive and antiproliferative activity, which translates into supe- rior efﬁcacy in preventing rejection episodes. However, the unequiv- ocal employment of the PSI, sirolimus, after de novo cardiac transplantation (Tx) has been hampered by the observation of a markedly increased incidence of surgical complications after engraft- ment. The inﬂuence of everolimus (EVL), a PSI with a modiﬁed pharmacokinetic proﬁle, on the incidence of incision-related compli- cations post heart Tx was compared with mycophenolate mofetil (MMF) and azathioprine (AZA). Methods and Materials: Pooled data of 1008 patients were analyzed from three randomized, multicenter, studies – B253 (n=634), A2403 (n=199), A2411 (n=176) – in which de novo heart transplant patients received ﬁxed-dose EVL or concentration-controlled EVL (target 3– 8ng/mL), AZA or MMF with standard or reduced cyclospor- ine (CsA). Data from 214 patients on AZA, 83 on MMF and 711 on EVL were analyzed for incidence, type and severity of incisional compli- cations up to Day 90 post Tx. Patient demographics and clinical conditions were comparable across all studies and cohorts. Results: Incisional complication events occurred in 21 (9.8%) AZA, 8 (9.6%) MMF and 91 (12.8%) EVL patients. Wound infection was the most frequent incisional complication. Mostly graded mild to moder- ate, wound infections were considered ‘severe’ in 12.5%, 16.7% and 10.3% of the cases for AZA, MMF and EVL, respectively. Conclusions: Incisional complications following heart Tx in the presence of EVL are comparable in clinical impact and severity to AZA- and MMF-based regimens. Diagnosis AZA n (%) MMF n (%) EVL n (%) Wound infection 16(7.4) 6(7.2) 68(9.6) Wound dehiscence 2(0.9) 1(1.2) 13(1.8) Sternal dehiscence 2(0.9) 0 7(1.4) Mediastinal infection 1(0.5) 1(1.2) 3(0.4) 298 Usefulness of mTOR Inhibitors for Treatment of Heart Transplant Patients with Non-Cutaneous Non-Lymphomatous Tumours: Data from the Spanish Post-Heart-Transplant Tumour Registry M.G. Crespo-Leiro 1 , L.A. Alonso-Pulpon 2 , V. Brosa 3 , J. Fernandez-Yanez 4 , L. Almenar-Bonet 5 , F. Fernandez-Vilchez 6 , J.F. Delgado 7 , N. Manito 8 , B. Diaz-Molina 9 , G. Rabago 10 , J.M. Arizon 11 , N. Romero 12 , E. Roig 13 , T. Blasco 14 , D. Pascual 15 , J. Muniz 16 1 Hospital Juan Canalejo, La Corun ˜a, Spain; 2 Hospital Puerta de Hierro, Madrid, Spain; 3 Hospital Sta Creu i San Pau, Barcelona, Spain; 4 Hospital Gregorio Maranon, Madrid, Spain; 5 Hospital La Fe, Valencia, Spain; 6 Hospital Valdecilla, Santander, Spain; 7 Hospital 12 de Octubre, Madrid, Spain; 8 Hospital Bellvitche, Barcelona, Spain; 9 Hospital Central Asturias, Oviedo, Spain; 10 Clinica Navarra, Pamplona, Spain; 11 H. Reina Soﬁa, Cordoba, Spain, 12 H. Virgen del Rocio, Sevilla, Spain; 13 H.Clinic, Barcelona, Spain; 14 H. Miguel Servet, Zaragoza, Spain; 15 H. Virgen Arrixaca, Murcia, Spain; 16 Instituto Ciencias Salud, La Corun ˜a, Spain Purpose: Malignancy is a major complication following heart trans- plantation (HT): in Spain, HT patients with solid non-cutaneous non-lymphoid (NSNL) tumours have 5 year mortality rates ranging from 23% for prostate cancer [95% conﬁdence interval (CI 95 ) 10-46%) to 88% (CI 95 78-95%) for lung cancer with dissemination at diagnosis; the overall rate is around 32%. mTOR inhibitors (mTORis) have both immunosuppressive and antitumoral properties, but their usefulness for treating HT patients with neoplasia is uncertain. This study evaluated whether mTORi treatment of HT patients with a post-HT NSNL tumour improves their survival time. Methods and Materials: The Spanish Post-Heart-Transplant Tumour Registry (SPHTTR) collects post-HT tumour data concerning all patients who have undergone HT in Spain since 1984. This study concerned the 287 patients (90% male) who up to December 2007 had had an NSNL tumour as a ﬁrst post-HT tumour. The survival of patients who were treated with mTORis following tumour diagnosis The Journal of Heart and Lung Transplantation Abstracts S169 Volume 28, Number 2S