[Update: Organ Donation and Preservation]

In recent years, we have witnessed remarkable progress in organ donation and the preservation of donor lungs. Several transformative innovations have been particularly influential:1. Normothermic ex vivo lung perfusion (EVLP): EVLP is a groundbreaking advancement in lung transplantation. This technology not only enables expansion of the donor pool by reconditioning marginal lungs, but also improves transplantation outcomes, through optimised assessment and therapeutic intervention prior to implantation. Lungs considered high-risk or initially unsuitable for transplantation can be evaluated and, in many cases, rehabilitated using EVLP, resulting in post-transplant outcomes comparable to those of conventionally selected lungs. With ongoing technological advancements and increasing clinical acceptance, EVLP could soon become the standard of care in lung transplantation.2. Donation after circulatory death (DCD): DCD has emerged as an essential strategy to address the shortage of transplantable lungs. Despite logistical challenges and ethical considerations, transplantation outcomes using DCD lungs are comparable to those achieved with traditional donation after brain death. As research and technology continue to advance, DCD donors are expected to play an increasingly significant role in lung transplantation.3. Controlled hypothermic preservation at 10 °C: Controlled hypothermic storage at 10 °C offers extended preservation times, reduces cold-induced injury, and enhances flexibility in transplant scheduling. This method has the potential to revolutionise the currently rigid logistics of lung transplantation, allowing semi-elective procedures to be integrated into daily surgical programs as research progresses.With a particular focus on these innovations, we aim to summarise the current state of knowledge regarding lung donors and donor lung preservation.