AbstractPulmonary embolization in donor lungs is a common finding and found in up to 38% of cases. To expand the pool of organs, transplant centers now utilize lungs, from increased risk donors, that may have pulmonary embolic disease. Modalities of clearing pulmonary artery embolisms are critical to reduce the prevalence of primary graft dysfunction post transplantation. There have been anecdotal cases of pulmonary embolectomy pre and post organ procurement orin vivoandex vivothrombolytic therapy performed in donors with massive pulmonary emboli. We report for the first time therapeuticex vivothrombolysis on the back table without Ex Vivo Lung Perfusion (EVLP), followed by successful transplantation.