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This 34th Adult Lung and Heart-Lung Transplant Report summarizes data from 60,107 adult lung and 3,992 adult heart-lung transplants performed through June 30, 2016, and reported to the International Society for Heart and Lung Transplantation (ISHLT) Registry. In addition to reporting key data for donor and recipient characteristics, transplant events, and recipient treatments and outcomes, this year’s report focuses on an overall theme of allograft ischemic time. We report geographic, center, donor, and recipient factors associated with variations in allograft ischemic time, associations of allograft ischemic time with outcomes, and other data of interest related to this topic. The Registry’s online slide sets show results from additional analyses and complementary information not included in this publication (see http://ishlt. org/registries/slides. asp? slides= heartLungRegistry/).