*Purpose: Cardiovascular disease is a common cause of mortality in patients with uncontrolled diabetes. The purpose of this study is to assess whether patients receiving pancreas transplants experience an improvement in overall cardiac function.

*Methods: Adult pancreas transplant patients between 2015-2018 with and without a history of clinical atherosclerotic cardiovascular disease (ASCVD) were included in this study. The primary endpoint of interest was change in cardiac outcome post-transplant, measured by change in surrogate markers, which included the Pooled Cohort 10-Year ASCVD risk score in patients with no ASCVD before transplant and left ventricular ejection fraction (LVEF) in those with ASCVD before transplant. As the risk score includes diabetes as a variable, we aimed to assess cardiovascular outcomes in this population.

*Results: Baseline demographics of 92 pancreas transplant recipients are displayed in Table 1. There were 21 patients with prior ASCVD and 71 patients with no prior ASCVD. A pre-transplant risk score was able to be calculated for 22 (24%) patients. Of 15 pancreas transplant recipients with pre and post-transplant ASCVD risk score, there was a significant reduction in ASCVD risk score post-transplant [8.8% vs. 4.2%, p=.0039, Figure 1]. Of note, only two patients had post-transplant ASCVD events, which occurred on the day of transplant and at five months post-transplant. Of 8 pancreas transplant recipients with pre-transplant ASCVD, there was an improvement in LVEF [60% vs. 67%, p=.0363, Figure 2]. Patient and graft survival at last follow up were 97.8% and 90%.

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*Conclusions: Pancreas transplant recipients with and without ASCVD experienced significant improvements in overall cardiac function, as well as few post-transplant ASCVD events. Although the study was limited by a high number of patients missing pre and post-transplant ASCVD risk scores, the Pooled Cohort 10-Year ASCVD risk calculator appears to serve as a reliable predictor of cardiac outcomes in pancreas transplant recipients without prior clinical ASCVD.

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