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Ex-Vivo Lung Perfusion (EVLP) can be used to improve the performance of donor lungs determined unsuitable for transplant prior to recovery or after intraoperative evaluation.This was a single OPO, single center study. Surgeons accepted lung offers for standard or EVLP recovery. Lungs were placed for EVLP recovery prior to the OR if there was no interest in standard recovery by local and national lung centers. Lungs were considered for EVLP on brain dead donors with a PaO2 of <300 mmHg and DCD donors. Additionally, EVLP was considered for lungs after intraoperative evaluation of lungs determined they were not acceptable for standard recovery.Over 4 years, 339 lung offers were accepted for transplant, 323 (95%) were accepted for standard recovery and 16 (5%) were accepted for EVLP recovery. There were 11 cases where lungs initially accepted for standard recovery were placed on EVLP. In 3 cases, lungs initially accepted for EVLP were recovered and transplanted without being placed on EVLP. Additionally, in 1 case, lungs initially accepted for EVLP were recovered and discarded without being placed on EVLP due to consolidation and pneumonia observed in the OR. Lungs placed on EVLP were transplanted 50% (12/24) of the time.EVLP increased the total number of lungs in this study period by 5% (12/248). OPOs should consider utilizing EVLP to not only increase the lung donor pool but also to salvage lungs initially thought to be able to be recovered in the standard fashion. More research is needed to better understand EVLP effects on transplant outcomes and cost.