32 double, and 18 single lung transplants were performed, 15 required cardiopulmonary bypass. Diagnosis included: IPF 18/50 (36%), emphysema 17/50(34%), cystic fibrosis 8/50(16%), pulmonary hypertension 4/50(8%), other 3/50(6%). 6 of 46 (13%) patients without primary pulmonary hypertentiosn had secondary pulmonary hypertension. The three month survival was 96%, actuarial 1-year survival 88%. The incidence of severe acute graft injury was 10%. Acute lung injury increased the time of intubation (2.34 vs.4.65;p  0.05), length of hospital stay (14.2 vs. 27.3 days; p  0.05), development of acute rejection (33% vs. 60%; p  0.05), and operative mortality (4% vs. 60%; p  0.05). No correlation was found between the development of acute graft injury and ischemic times or donor pO2. Implementation of well described clinical techniques donor pro- curement and reperfusion may reduce the incidence of severe reperfusion injury. Prospective studies to examine the relative con- tribution of each intervention are needed. A decreasing rate of severe reperfusion injury may allow for the relaxation of donor criteria and further expansion of the donor pool. 328 QUANTIFYING THE RESUSCITATION OF HEARTS PROCURED FROM NONHEARTBEATING DONORS WITH RADIOLABELED ANNEXIN V D. Prastein, 1 J. Gu, 1 A. Wright, 1 M. Kwon, 1 B. Line, 1 B. Griffith, 1 R.N. Pierson, 1 F. Gage, 2 R. Poston, 11 Division of Cardiothoracic Surgery, University of Maryland School of Medicine, Baltimore, MD; 2 Organ Recovery Systems, Inc., Des Plaines, IL Objective: Donor hearts that have arrested and been resuscitated in situ are often accepted, but hearts from nonheartbeating (NHB) donors that cannot be screened for irreversible warm ischemic damage are rejected for transplantation. We quantified the resuscita- tion of nonheartbeating hearts by measuring apoptosis using Tc-99 annexin V. Methods: Six dogs were exanguinated and their hearts exposed to varying lengths of warm ischemia. After cardiectomy, the hearts were placed in an asanguinous metabolic support system (ORS infusion pump) for continuous ex vivo perfusion. The hearts were scanned 1 hour after Tc-99 annexin V was injected into the circuit. Apoptosis was confirmed on heart biopsy using caspase immunohistochemistry. Results: Heart radioactivity counts assessed by both whole organ SPECT and planar images correlate with degree of warm ischemic injury (figure 1, left-0 minutes, right-20 minutes warm ischemia). The same correlation was found when using scintigraphy to determine the amount of radioactivity (mCi/gm) in heart biopsies. In vitro evidence of caspase 3 activation further confirmed the accuracy of this imaging protocol. Conclusions: Whole organ SPECT scanning with Tc-99 annexin V provides a noninvasive means of quantifying degree of myocardial apoptosis, and could potentially serve as a screening tool to assess viability of NHB donor hearts. Degree of apoptosis correlated with the length of warm global ischemia as confirmed by SPECT scan, scintig- raphy counts, and in vitro analyses of heart tissue. 329 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION FOR SEVERE GASTROPARESIS AFTER LUNG TRANSPLANTATION J.G. Weinkauf, 1 R.C. Robbins, 2 J. Theodore, 1 J.L. Faul, 1 1 Pulmonary and Critical Care Medicine, Stanford University Medical Center, Stanford, CA; 2 Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA Gastroparesis is a serious complication of lung transplantation. Some lung allograft recipients with severe gastroparesis have symptoms refractory to dietary modifications and gastric promotility agents. Here, we report two lung allograft recipients in whom transcutaneous electrical nerve stimulation (TENS) effectively reversed symptoms of gastroparesis. Both patients (a 26-year old male and a 54-year old female) received bilateral lung allografts for cystic fibrosis, but developed severe gastroparesis associated with complaints of early satiety, epigastric pain, and abdominal bloating. Promotility agents (cisapride and metoclopramide), gastric acid suppression and anti- emetics provided partial relief for their symptoms for 18 months in the first case and 9 months in the second. Significant weight loss (average of 7 kg) occurred within the first 3 months post transplan- tation. In the first case esophagogastroduodenoscopy revealed a large gastric bezoar. Neither patient had a gastric outlet obstruction. The first patient received TENS from an Isotron 1000 (XLTEK) for 30 minutes daily over 21 days. The second patient received TENS from an INS PLUS (Biomedical Life Systems) for 30 minutes daily over 19 days. The electrodes were positioned over the lower back. TENS resulted in a rapid alleviation of symptoms. Both patients stopped cisapride and metoclopramide within 3 weeks. They remain off all medical therapy for gastroparesis, without symptoms, and are cur- rently on regular diets. The average weight gain after starting TENS was 7.5kg (8kg and 7 kg respectively) within 3 months. We conclude that lung transplant recipients with severe gastroparesis may derive significant benefit from TENS. 330 THE ROLE OF SELF-EXPANDABLE METALLIC STENTS (SEMS) IN PROMOTING HEALING OF POST LUNG TRANSPLANT BRONCHIAL DEHISCENCE M.M. Mughal, 1 T.R. Gildea, 1 S. Murthy, 2 M. DeCamp, 2 G. Pettersson, 2 A.C. Mehta, 11 Pulmonary & Critical Care, The Cleveland Clinic Foundation, Cleveland, OH; 2 Thoracic & Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, OH Introduction: Improvements in patient selection, surgical tech- nique, and immunosuppressive therapy have reduced yet not elimi- nated the occurrence of anastamotic dehiscence after lung transplan- tation (LTx). Bronchial dehiscence (BD) occurs early, is difficult to treat, and is associated with high mortality. We describe our experi- ence utilizing SEMS to treat post LTx BD. Methods: Retrospective analysis of the course and outcome of patients with grade III and IV BD treated with SEMS. Results: From January 1995 to June 2003 158 single and 104 double LTx were performed in our institution totaling 366 bronchial anasta- mosis. Five cases of BD (grade III & IV, 4 right & 1 left) were treated with SEMS (1.36%). All were men with single LTx and mean age of 53  9.6 years. Interval between LTx to diagnosis of BD was 23.4  17.5 days. All patients presented with respiratory distress and 2 required mechanical ventilation. BD progressed despite intercostal muscle flap bronchoplasty in one and bronchial omentopexy in another. SEMS insertion resulted in complete bronchial healing and significant improvement in FEV1 in 4 patients. One patient died 10 days post-SEMS insertion from pulmonary emboli. Anastamotic heal- ing was present as early as 1 week. Mean follow-up of all patients was The Journal of Heart and Lung Transplantation Abstracts S153 Volume 23, Number 2S