Purpose: In order to improve the rate of succesful heart trans- plantations, organ preservation should be optimized. Iron-depen- dent oxidative damage and iron-independent chloride-dependent injury of the coronary endothelium after cold ischaemic storage and reperfusion lead to complications and unfavourable outcome. This study tested the effects of iron chelator supplementation in different HTK organ preserving solutions on endothelial function in a long-term storage model on isolated rat aorta. Methods and Materials: Isolated aortic rings underwent a 24h cold ischaemic preservation in different HTK-solutions (Custo- diol ® , chloride-poor HTK-1 solution, chloride-poor HTK-2 solution containing high-dose N-acetyl-L-histidine) supplemented with iron chelators of low (deferoxamine, Def) and high (LK-614) membrane permeability. In vascular reactivity measurements we investigated the contraction, endothelium-dependent and –inde- pendent vasorelaxation by using cumulative concentrations of acetylcholine (ACh) and sodium nitroprusside with/without an additional external oxidant injury (OCl - 200M) during reoxygen- ation. Results: Custodiol ® failed to prevent endothelial dysfunction in our experiments. Chloride-poor HTK-solutions containing N- acetyl-L-histidine and/or supplemented with LK-614 but not with Def resulted in a significant improvement of endothelial function, moreover a complete protection of the endothelium was feasible after 24h cold storage. Endothelium-independent vascular functions have not been af- fected in any groups. Conclusions: Our results demonstrate the importance of iron- dependent oxidative injury in the development of endothelial dys- function after cold storage, which can be prevented by cell perme- able iron chelators. 452 Non-Utilization of Donor Organs for Non Medical Reasons – Impact on Patients Waiting for Heart and Lung Transplantation C. Van De Wauwer, 1 M. Villavicencio, 1 N. Wrightson, 1 T. Butt, 1 S.C. Clark, 1 T. Pillay, 1 K. Tocewiczs, 1 S. Ledingham, 1 J. Forty, 1 S. Schueler, 11 Department of Cardiopulmonary Transplantation, Freeman Hospital, Newcastle upon Tyne, United Kingdom Purpose: Public perception of donor shortage focuses on donor families refusal to consent for organ donation as the main reason for long waiting times and potential death on the waiting list. In order to identify non medical reasons for decline of suitable donors we reviewed retrospectively our donor and recipient data between 01/2002 and 12/2006. Methods and Materials: A total number of 2662 donors were offered to our transplant centre. Out of these 288 medically suitable donors were declined due to non medical reasons. During this time period 365 heart, lung and heart-lung transplantations have been performed. In group I (n = 90) the reason was the lack of intensive care unit beds, group II (n = 72) there was no second surgical team, group III (n = 73) no transport and group IV (n = 54) miscellaneous, respectively. Results: For 93 (32%) donor organs a suitable recipient was on the waiting list at the time of the offer (67 lung recipients and 26 heart recipients). The non use of donor organs resulted in a waiting time for the suitable lung transplant recipients of 398  70 days and in heart transplant recipients of 160  28 days. During this time period 16 suitable lung recipients and 5 heart recipients passed away before transplantation (7%). At the end of the study, 18 recipients (17 lung, 1 heart) were still awaiting transplantation. If all donors would have been used for suitable recipients, an increase of 25% of the transplant activity would have been possible. Conclusions: The number of suitable donor organs is significantly higher than the number of transplants performed. Awareness should be directed towards improving infrastructure and logistics within transplant centres in order to reduce waiting time and prevent death on the waiting list. 453 Lung Allograft Evaluation of Rejected Extended Criteria Donors C.H. Wigfield, 1,2 J.D. Lindsey, 1 J. Anderson, 1 R.B. Love, 2,3 1 Cardiopulmonary Transplantation, University Wisconsin Hospitals, Madison, WI; 2 Cardiopulmonary Transplantation, Freeman Hospital, Newcastle upon Tyne, England, United Kingdom; 3 Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL Purpose: The waiting list mortality for lung transplantation is unac- ceptably high. Donor shortage is the limiting factor and assessment of allograft adequacy depends on few surrogate markers and predomi- nantly subjective clinical judgement. We analyzed organ procurement data sets of rejected extended criteria donor offers. Methods and Materials: 241 rejected potential donors were re- viewed (2004/5). Organ procurement data sets (OPDS) were evalu- ated for demographic data, clinical details, cause of death, presence of aspiration (Asp) and/or infection (Inf) as well as bronchoscopic findings (Bronch) and ventilatory oxygenation indices (OI) and reasons for rejection. Univariate and multivariate analysis was per- formed of factors assessing marginal allografts. Results: Median, (range): Age 42(776), BMI 25 (13-46), 19.8%  BMI 30, Causes of donor Death were: CVA 44.4%, SICP 9.2%, other 33.8%, unknown 12.6%. 56.3% were smokers at the time of death, preva- lence of asthma 5.3% and drug abuse 19.9%. Baseline PO 2 148 (31-379 mmHg) and PO 2 challenge 417 (92-673 mmHg). Aspiration was confirmed in 8.6% and 52.3% received no bronchoscopy. Pulmonary infection was present in 16.5% with 7.3% of potental donors receiving no specific evaluation. Reasons cited for rejection of extended criteria donors were: quality of allograft 43.7%, size mismatch 11.3%, age of donor 11.9%, specific clinical concerns 12.6%, logistic factors 11.9% and DCD donors 3.9% and no reason stated in 4.4%. Conclusions: The prevalence of clinical donor risk factors such as smoking history and aspiration or infection, may not correlate with oxygenation indices during allograft assessment. Rejection of lung donors was rarely dependent on FiO 2 challenge alone. Bronchoscopic analysis is not readily available for more conclusive allograft evalua- tion prior to arrival of procurement teams. In absence of predictive The Journal of Heart and Lung Transplantation Abstracts S223 Volume 27, Number 2S