two from a child with renal transplant were found hMPV positive. The majority of cases clustered within two outbreaks in October/ November and March. In immunocompromised patients hMPV was isolated throughout the whole observation period. The same viral strains circulated in hospitalized children and lung transplant recipi- ents. A different strain was isolated during the interepidemic period, suggesting that hMPV infections may occur independently from the community outbreak situation in lung transplant recipients. Clinical signs and symptoms varied from no symptoms to severe pneumonia or acute graft rejection. Of interest, the identification of replicating hMPV significantly correlated with the occurrence of rejection symp- toms at the timepoint of sample collection. This suggests that hMPV may be added to the list of pathogens possibly associated with episodes of allograft rejection. 44 PULMONARY RETRANSPLANTATION FOR PATIENTS WITH THE BRONCHIOLITIS-OBLITERANS-SYNDROME - A SINGLE CENTER EXPERIENCE J. Gottlieb, 1 B. Gohrbandt, 2 J. Niedermeyer, 1 T. Welte, 1 M. Strueber, 21 Respiratory Medicine, Hannover Thoracic Transplant Program, Hannover Medical School, Hannover, Germany; 2 Cardiothoracic and Vascular Surgery, Hannover Thoracic Transplant Program, Hannover, Germany Pulmonary retransplantation (ReTx) occasionally is performed be- cause of bronchiolitis obliterans syndrome (BOS) after primary lung transplantation (LTX). Previous results showed better survival of BOS-patients after ReTx compared to other indications. The preva- lence of advanced BOS was reported to be more frequently in patients re-transplanted because of BOS. Outcome Data between 1988 and 2003 of primary LTX and ReTx for BOS were compared in our program. BOS was defined to be present when forced expiratory volume in 1 sec falls below 80% of the baseline value exluding other reasons. 35 (9 single, 26 double LTX) out of 55 ReTx-procedures were performed because of progressive BOS at a mean of 933656 days after primary LTX. Mean age was 349 years in these 35 recipients. Primary indications for LTX was cystic fibrosis in 17, pulmonary fibrosis in 7, pulmonary hypertension in 4, and other indications in 7 recipients. 561 primary LTX procedures were compared. The 1, 3, 5 and 10 year cumulative survival rates were 71% , 60%, 45% and 17% after ReTx. Survival rates after primary LTX were 76%, 68%, 59% and 41% after 1, 3, 5 and 10 year respectively. The prevalence of BOS was 20% , 19%, 43% and 64% at 1,2,3 and 5 years respectively after pulmonary ReTx (n=27). Prevalence in primary LTX recipients was 9%, 15%, 26% and 57% at 1,2,3 and 5 years respectively (n=399). Mean occurence of obliterative bronchiolitis was 616435 days after pulmonary ReTx compared to 932657 days after primary LTX (p=0.63, n.s.). 2 out of 12 recipients with early (2 year) manifestation of BOS after primary LTX survived more than 10 years after ReTx. In this single center observation pulmonary ReTx was an option for intractable cases of the bronchiolitis obliterans syndrome after primary LTX. There was no significant difference in occurance of BOS in ReTx- and primary LTX recipients. 45 DOES PHOTOPHERESIS HAVE A ROLE IN THE BATTLE AGAINST BOS? D.C. McGiffin, 1 R.N. Brown, 1 J.K. Kirklin, 1 K.H. Hart, 1 K.R. Young, 2 G.L. Zorn, 1 K.J. Leon, 2 K.M. Wille, 21 Surgery, University of Alabama at Birmingham, Birmingham, AL; 2 Pulmonary, University of Alabama at Birmingham, Birmingham, AL Bronchiolitis obliterans syndrome (BOS) is a major factor limiting long term survival after lung transplantation. A variety of pharmacologic immunosuppression modalities have been used without clear benefit. Photopheresis (photo) is associated with airflow stabilization in individual cases, but objective evidence for efficacy is lacking. This study examines the efficacy of photo in preventing loss of airflow to a higher grade of BOS or BOS death. Methods: Between June 1988 and Dec 2003, 356 single, double and heart/lung transplants were performed. Forty-seven patients (pts)un- derwent at least 3 months of photo for BOS. Pts were entered into modulated renewal analysis, modulating at BOS grade 1, 2&3. Photo was entered into the model as a time-varying covariate. Results: By multivariable analysis, selection for photo therapy (but prior to photo) identified pts who were already in BOS grade 2 as being in a “high risk group” for progression to BOS grade 3 or BOS death (0.85 events/yr), but following photo, this event rate fell to 0.5/yr, which was not different from the event rate in a group of pts with BOS grade 2 without risk factors for progression (low risk group) (Figure 1). Conclusions: This study provides evidence that in pts with BOS grade 2, the rate of loss of airflow may be slowed with photo, although this effect is relatively small. However, given the multiple non-immunologic causes that may lead to a final common pathway of small airway injury, any beneficial effect of photo on immunologic mechanisms may have been diluted. There is sufficient evidence of the stabilization of loss of airflow in BOS by photo to continue to explore the application of this therapy. 46 SINGLE CENTRE EXPERIENCE WITH BRONCHIAL HEALING AFTER LUNG TRANSPLANTATION: A REVIEW OF 555 ANASTOMOSES M. Jeyakanthan, 1 Q. Abid, 1 T. Pillay, 1 S.C. Clark, 1 J.H. Dark, 1 S. Schueler, 11 Cardiopulmonary Transplantation Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom Background: Since the beginning of our transplant programme in 1987 we used various techniques of bronchial anastomosis including continuous and interrupted sutures, in addition a pedicled graft as a bronchial wrap using omentum, pericardium or intercostal muscle. Since the early nineties we adopted a technique that included: i) Short donor bronchus one cartilaginous ring proximal to the upper lobe origin ii) End-to-end anastomosis by continuous suture of membra- nous bronchus and interrupted figure-of-eight suture of the cartilagi- nous bronchus using non absorbable sutures avoiding telescoping iii) Apposition of peribronchial tissue over the anastomoses. S56 Abstracts The Journal of Heart and Lung Transplantation February 2005