RESULTS: 908 LTR were eligible for inclusion with 56 (6%) LTR having at least one PE event during the follow up period (905 days median). Of the 695 LTR with sufficient data to assess for CLAD, PE was strongly associated with the subsequent risk of CLAD (HR 2.509, p <0.001). In the entire cohort of 908 LTR, a PE event was also strongly associated with the development of airways stenosis (p<0.0001). PE was considered in time independent survival models at 180 days and 1 year. A PE in the first 180 days was strongly associated with death (HR 5.0082, p = 0.03). However, a PE within one year after transplant was not associated with an increased risk of death. When PE was considered as a time dependent variable considering all available follow up, PE was strongly associated with worse survival (HR 2.548, p <0.001).