*Purpose: The purpose of this study is to determine if pre-operative cyclosporine (Cya) decreases the rate of primary graft dysfunction (PGD) in patients undergoing orthotopic heart transplant (OHT).

*Methods: Retrospective, single center study of 172 OHT recipients between 7/2013 and 6/2018. Primary endpoint was incidence of PGD within 24 hours post-OHT in patients who did and did not receive pre-operative cyclosporine. Secondary endpoints were PGD subcategories used at our institution (right ventricular (RV) PGD, moderate left ventricular (LV) PGD, and severe LV PGD). RV PGD was defined as LV ejection fraction (LVEF) >40% requiring a RV assist device (RVAD), moderate LV PGD was defined as LVEF ≤40% and requiring intra-aortic balloon pump (IABP), and severe LV PGD was defined as LVEF ≤40% requiring mechanical circulatory support. Other endpoints include patient/graft survival at 30 and 90 days, ICU and hospital lengths of stay, duration on inotropic/vasopressor support, and renal function within 7 days post-OHT. To account for selection bias of Cya treatment, 1:1 propensity score matching was performed.

*Results: A total of 172 patients were matched with no significant differences in baseline characteristics between the two groups (Table 1). PGD occurred in 20.9% of Cya and in 20.9% of non-Cya patients (p=1). No significant differences were seen in all secondary endpoints including patient and graft survivals (Table 2).

*Conclusions: In this study, pre-operative cyclosporine did not affect the rate of PGD, suggesting that its use may not be beneficial in OHT recipients.

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