Immune Modulating formulas containing arginine and omega-3 fatty acids used perioperatively in elective surgical patients and postoperatively in trauma patients is associated with substantial reduction in infections and shorted length of stay.   These effects are proposed to be due to improvement in organ perfusion, production of anabolic hormones, stimulation of wound healing and augmentation of the immune system.  Use of these products in transplantation has been limited by concerns for graft rejection.  This presentation will review research concerning use of Immune Modulating formulas in transplant patients and explore the potential for use in transplant.