In this article, the authors evaluate a novel lung preservation strategy for uncontrolled donation after circulatory death by combining lung inflation with topical cooling. Using a porcine model with 1.5 hours of warm ischemia, lungs preserved with combined inflation and cooling demonstrated superior post-transplant oxygenation, higher dynamic compliance, lower pulmonary edema, and reduced histological injury compared with cooling or inflation alone. Apoptosis and vascular injury were also attenuated. These findings indicate that simultaneous inflation and cooling synergistically may mitigate warm ischemic damage. Together, this offers an approach that may substantially increase utilization and early functional outcomes of lungs from uncontrolled donation after circulatory death donors.