Sodium Nitrite in Lung Transplant Patients to Minimize the Risk of Pulmonary Graft Dysfunction

Inclusion Criteria: * Subjects undergoing lung transplantation. * Subjects in the age range of 18-70 years * Ability to understand and provide consent. Proxy consent will not be accepted. Exclusion Criteria: * Donor exclusion criteria * Age \> 55 years. * Mechanical ventilation \> 5 days prior to procurement * Significant chest trauma or lung contusion * Smoking history \> 20 pack-year * Ratio of arterial oxygen partial pressure to fractional inspired oxygen \< 300 * Donor radiograph with 2 quadrant infiltrates * Donor that are determined single lung donors prior to transplant will be excluded. Recipient exclusion criteria * Recipient age \> 70 years. * Recipient history of pulmonary hypertension (idiopathic pulmonary arterial hypertension, or secondary pulmonary arterial hypertension with mean arterial pressure \> 30 mm Hg) * Recipient history of abnormal cardiac function defined as prior coronary artery bypass graft (CABG) or left ventricular ejection fraction (LVEF) \< 45 % * Recipient history of open thoracotomy/prior pleurodesis as exclusion criteria. However patients who have had limited video-assisted thoracic surgery procedures for biopsies would NOT be excluded from the study. * Recipient history of cirrhosis * Recipient history of mechanical ventilation or extracorporeal support pre-operatively * Recipient pre-operative hypotension defined by a systolic blood pressure less than 90 mm Hg not responsive to intravenous fluids or requirement for vasoactive medicati…