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DISCUSSION: Adenocarcinoma of the lung is an indication for lung transplantation but is rarely performed for this indication (1). In a retrospective study of the United Network for Organ Sharing registry, 15 out of 21,533 lung transplants were performed for bronchioalveolar cell carcinoma (BAC) with comparable outcomes to other diagnosis (2). To our knowledge this is the first case of a lung transplant performed utilizing grafts that underwent EVLP in a patient with metastatic lung adenocarcinoma.

CONCLUSIONS: Expansion of the donor pool with technologies like EVLP (3) and bioengineered lungs, the development of new cancer therapies, and individualized immunosuppression regimens could potentially expand the candidacy for lung transplantation to patients with advanced lung adenocarcinoma.