To examine the prevalence and short/long-term outcomes of LTx recipients after prior cardiac surgery (coronary artery bypass grafting [CABG] and valvular surgery). The UNOS/OPTN database was queried from 5/05-3/21 for LTx recipients. Exclusion criteria included age<18, retransplantation and multivisceral transplantation. Patients were stratified on prior cardiac surgery (No Surgery [NS], Prior CABG [CABG], Prior Valve [Valve]). Endpoints included long-term survival, perioperative mortality, length of stay, postoperative stroke or dialysis, and cause of death. 28,754 LTx patients were identified, 511(1.8%) had prior CABG and 84(0.3%) had prior valve surgery. Prior to matching, the NS group was significantly younger, less commonly male, and had lower median lung allocation scores. There were also significantly less bilateral lung transplants in the CABG and valve surgical groups. Median length of stay (LOS) varied amongst the groups, but there were no significant differences in postoperative stroke, dialysis, or in-hospital mortality. There was an increased incidence of cardiac/cerebrovascular death in CABG recipients (18.4%) and malignancy death in Valve recipients (23.3%) (p< 0.01). Following matching, CABG 5-year survival (38.0%) was lower than NS (47.8%) (p<0.01), while there was no significant difference in 5-year survival between NS (45.7%) and Valve (38.1%) (p=0.17) (Figure 1). CABG and Valve groups had decreased overall survival, however, comparison to similar recipients following matching demonstrates survival is not prohibitive to transplantation. Due to potential for increased risk of cardiovascular mortality, providers should evaluate the burden of vascular disease in potential recipients with prior CABG towards improving outcomes. [ABSTRACT FROM AUTHOR]