991 This study analyzes pregnancy outcomes in female lung transplant recipients. Data were obtained through questionnaires, telephone interviews and hospital records. Outcomes of 10 pregnancies in 9 lung recipients included 5 livebirths (mean birthweight [BW] in gms = 2138, mean gestational age [GA] in wks = 34), 4 therapeutic abortions and 1 spontaneous abortion. Of the 5 livebirths, 3 were delivered by Cesarean section. Three infants were severely premature (<32 wks). Neonatal complications occurred in 4 infants as follows: bradycardia with cardiac monitoring for 4 months (GA 31.5, BW 2665), hyaline membrane disease (GA 30, BW 1616), mild hypoglycemia (GA 40, BW 3005), adrenal suppression and necrotizing enterocolitis (GA 30, BW 1077). The mean transplant to conception interval was 2±1.4 yrs (range 0.7-4.7 yrs). Immunosuppressive regimen included 8 cyclosporine (Sandimmune® 7, Neoral® 1) and 2 tacrolimus (Prograf™). During pregnancy 5 recipients had no change in maintenance immunosuppression, 3 had increased dosing, and 1 varied dosing. Maternal comorbid factors during pregnancy included hypertension (n=7 recipients), diabetes (n=1), infection (urinary tract n=1, pneumonia n=1 [pneumocystis carinii at 5 months and aspergillus at 7 months]). There were no cases of pre-eclampsia. Rejections were reported in 4 (40%) pregnancies and were treated with methylprednisolone (3); methylprednisolone and plasmapheresis (1). Of these 4, 2 have reduced graft function and 2 were re-transplanted at 5 and 10 months post-partum, respectively (1 with current function and 1 death at 20 months post re-transplant). The remaining 5 have adequate lung function. There were no neonatal deaths or reports of any structural malformations in the newborn. Follow-up of the children (age 0.9 to 5.6 yrs) has shown normal development with no subsequent problems. CONCLUSIONS: When compared to other solid organ recipients, female lung recipients may face higher risks with regard to pregnancy, particularly related to rejection. Whether pre-pregnancy factors can help to predict which recipients are at risk for adverse outcomes requires further study. Supported by grants from Sandoz, a Division of Novartis Pharmaceuticals Corporation, Fujisawa Healthcare, Inc., and Roche Laboratories, Inc.