In this single-center retrospective review from the Toronto Lung Transplant Program, a two-surgeon donor-review system in which lungs declined by the primary on-call surgeon were reassessed by a second surgeon salvaged 34 transplants from initially declined offers in the span of two years. This increased transplant volume by 8.6 percent, with early outcomes—including grade 3 primary graft dysfunction, postoperative extracorporeal membrane oxygenation (ECMO), extubation time, length of stay, and survival—comparable to lungs accepted on first review.
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