s S155 Takayama,1 Y. Naka.1 1Surgery, Columbia University Medical Center, New York, NY; 2Biostatistics, Columbia University Medical Center, New York, NY; 3Medicine, Columbia University Medical Center, New York, NY. Purpose: Implantable left ventricular assist devices (iVAD) have been widely used for patients with end-stage heart failure as a bridge to heart transplantation (HTx). There is an increasing population of patients who require bridging with a temporary ventricular assist device (tVAD), either with or without an iVAD. Outcome of these patients after HTx is unknown. Methods: Between January 2007 and April 2015 there were 430 patients cared for at this institution who underwent OHT. Patients were further grouped by the algorithm of support device prior to their HTX as no bridge (Group A, n= 248), single bridge with tVAD (Group B, n= 17), single bridge with iVAD (Group C, n= 148) and multiple bridges with tVAD and iVAD (Group D, n= 17). Primary outcome was survival after HTX. Results: Patients in group B were more likely to be younger compared to the others (A:52±13, B:46±16, C:54±13, D:54±11, years, respectively, p= 0.059) and have lower body mass index (A:25.4±5.0, B:23.6±4.6, C:27.0±4.7, D:25.6±6.3, kg/m2, respectively, p= 0.008). Patients bridged with iVAD (bridge groups C and D) had lower total bilirubin at the time of HTX (A:1.2±1.0, B:1.1±0.8, C:0.9±0.8, D:0.8±0.3, p= 0.078). In-hospital mortality rate after HTx was not significantly different between groups (A: 8.5%, B: 11.8%, C:11.7%, D:11.7%, p= 0.660). The 1-year survival for group D was comparable to groups A and C, while 1-year survival for group B is significantly lower than any other groups (90.2%, 70.6%, 88.3% and 87.8%, respectively, p= 0.018). Conclusion: Post HTx survival in patients requiring multiple bridges was similar to those in non-bridge or single bridge with iVAD patients.