of death. Renal protective strategies are required to prevent the development of ESRD. 382 HEMORRHAGIC SHOCK AND RESUSCITATION IN ORGAN DONORS: L-ARGININE IMPROVES IMPAIRED LUNG TRANSPLANT FUNCTION G. Pressler, 1 H.U. Ebersberger, 1 I.V. Huff, 1 M.E. Eichhorn, 1 K. Messmer, 2 K.W. Jauch, 1 F. Loehe, 11 Department of Surgery, University Hospital Grosshadern, Munich, Germany; 2 Institute for Surgical Research, University Hospital Grosshadern, Munich, Germany Purpose: Organ donors are frequently trauma patients associated with hemorrhagic shock and resuscitation (HSR). The aim of this study was to investigate lung grafts from donors compromised by HSR and to assess the influence of L-arginine (L-Arg) on transplant function. Procedures: 18 pigs (27  0.7 kg) underwent left lung transplanta- tion. In the control group (Control; n  6), donor lungs were flushed (60 ml/kg 4°C cold Perfadex) and harvested. In the HSR- (n  6) and HSR/L-Arg-group (n  6) donors were hemorrhaged by 40 %, maintained in shock for 120 min and resuscitated (Ringer’s lactate, 4x shed blood volume) over 180 min. Following 18h hypothermic storage, lungs were transplanted and function (arterial pO 2 [mmHg] and pulmonary vascular resistance PVR [dynes x S x cm 5 ]) assessed in isolated ventilation/perfusion after 30 min, 2, 4 and 6 hours. Recipients received either saline (Control/HSR-group) or L-arginine (HSR/L-Arg-group) as bolus (50 mg/kg) followed by an infusion (100 mg/kg/h) over 2 hours iv. Finally, graft weight-gain was measured and bronchoalveolar lavage (BAL) taken. Results: Gas exchange was significantly impaired in the HSR-, not in the HSR/L-Arg-group. PVR was significantly elevated after 30 min reperfusion in the HSR-group (Tab.). BAL-leukocyte fraction (Control: 43  11%; HSR: 65  8%; HSR/L-Arg: 38  8%) and graft weight-gain (Control: 66  12%; HSR: 84  24%; HSR/L-Arg: 46  17%) tended to higher values in the HSR-group. Conclusion: HSR in donors increased ischemia-reperfusion-injury in lung transplants. L-arginine improved graft function and prevented a severe ischemia-reperfusion-injury in compromised donor lungs. Lung Graft Function 30 min 2h 4h 6h Control PaO2 [mmHg] 437  37 444  52 464  41 481  27 PVR [dynes  S  cm-5] 637  111 774  153 776  152 775  146 HSR PaO2 [mmHg] 229  29* 309  44 258  35* 273  20* PVR [dynes  S  cm-5] 1371  335* 984  163 993  65 882  100 HSR/L-Arg PaO2 [mmHg] 420  49 462  41 458  44 425  35 PVR [dynes  S  cm-5] 665  130 802  183 662  69 537  75 mean  sem; *p  0.05 vs Control. 383 NEBULIZED N-ACETYL CYSTEINE PROTECTS THE PULMONARY GRAFT FROM THE NON-HEART-BEATING DONOR INSIDE THE CADAVER F. Rega, 1 W. Wuyts, 2 B. Vanaudenaerde, 2 N. Jannis, 1 A. Neyrinck, 1 T. Lerut, 3 G. Verleden, 2 D. Van Raemdonck, 1,3 1 Center for Experimental Surgery and Anaesthesiology, KU Leuven, Leuven, Belgium; 2 Laboratory of Pneumology, KU Leuven, Leuven, Belgium; 3 Department of Thoracic Surgery, University Hospital Gasthuisberg, Leuven, Belgium Background: The use of lungs from non-heart-beating donors (NHBD) might significantly alleviate the organ shortage. Although the length of tolerable warm ischemia following cardiac arrest is limited, sufficient time is needed to organize family consent and organ retrieval. Novel methods to protect the warm ischemic lung inside the cadaver are therefore mandatory. Methods: Pigs (30.8  0.7 Kg) were sacrificed, left untouched for 3 hours and divided in 3 groups. Nebulized N-Acetyl Cysteı ¨ne (300 mg)[NAC], a precursor of the anti-oxidant agent Glutathione, was administered during 10 minutes, prior to death in group I [NAC- NHBD, n  6], or 15 min after death in group II [NHBD-NAC, n  6]. In group III no aerosol was administered [NHBD, n  6]. After a 3 hour warm ischemic interval lungs in all groups were cooled for one hour. Thereafter the left lung was prepared for evaluation in an isolated reperfusion circuit. Haemodynamic, aerodynamic and oxy- genation parameters were measured. Wet/Dry weight (W/D) was calculated after reperfusion. The right lung was used for measure- ment of reduced (GSH) and oxidized Glutathione (GSSH) levels (mol/g) in lung homogenates. Results: Results are listed in Table (*p  0.05 NHBD vs. NAC-NHBD; †p  0.05 NHBD vs. NHBD-NAC; N.S. NAC-NHBD vs NHBD-NAC). Conclusion: Nebulized NAC, administered prior or shortly after death, attenuates ischemia reperfusion injury via upregulation of Glutathione. NAC might be a promising tool to protect the NHBD pulmonary graft from warm ischemic damage inside the cadaver. Group Pulmonary Vascular Resistance (Dynes  sec  cm-5) Mean Airway Pressure (cm H2O) Oxygenation Index (AwP  % FiO2)/pO2) W/D GSH/GSSH NAC-NHBD 1930  144* 14.2  0.5* 1.84  0.12 7.4  0.4* 1.74  0.12* NHBD-NAC 1837  180 † 13.3  1.2 † 1.77  0.05 7.3  0.3 † 1.67  0.13 † NHBD 5051  530 17  1.4 1.89  0.06 8.5  0.1 1.15  0.09 384 IMPROVED VIABILITY AND REDUCED APOPTOSIS IN SUBZERO 21 HOURS PRESERVATION OF TRANSPLANTED RAT HEARTS USING ANTIFREEZE PROTEINS G. Amir, 1 B. Rubinsky, 2 L. Horovitz, 3 B.S. Yousif, 1 J. Leor, 3 A.K. Smolinsky, 1 J. Lavee, 11 Heart Transplantation Unit, Dept. of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Israel; 2 Dept.of Bioengineering and Dept of Mechanical Engineering, University of California, Berkeley, CA; 3 The Neufeld Cardiac Research Institute, Tel Aviv University, Tel Aviv, Israel Introduction: Arctic fish survive subzero temperatures by producing antifreeze proteins (AFP’s) which lower the freezing temperature of their body fluids. The aim of this study was to evaluate whether AFP’s enable prolonged cryopreservation of mamalian heart free of freezing, with improved survival and viability and reduced apoptosis following transplantation. Methods: In preliminary isolated rat heart perfusion experiments hearts were preserved for 24 and 28 hrs using UW, UW and AFP I or UW and AFP III at 4°C and 1.3°C (overall 60 exp.). Based on data acquired, hearts were preserved for 18 and 21 hrs with similar solutions and temperatures and heterotopically transplanted into isoimmunic rats (overall 56 transplants). 24 hrs post transplant evaluation consisted of echocardiography, viability scores (graded from 1-poor contraction to 6-excellent contraction, blindly and independently by 3 reviewers from video taped experiments), and HE and TUNEL staining of nuclei for apoptosis. Results: Isolated hearts- All hearts preserved for 24 hrs at 1.3°C without AFP’s froze and died upon reperfusion while all hearts preserved at 1.3°C for 24 and 28 hrs using AFP’s survived. Four of the 6 hearts preserved at 4°C with UW for 28 hrs died upon reperfusion. Developed pressure of hearts preserved for 24 hrs at 1.3°C using AFP’s was better than those preserved at 4°C with UW (1.4 vs 0.8, p  0.05). The Journal of Heart and Lung Transplantation Abstracts S171 Volume 23, Number 2S