Heart and lung transplantation have become standard therapy for many patien
ts with end-stage heart and lung disease. Successful transplantation requir
es preservation of allografts until they can be implanted and reperfused. I
n the decades since the transplantation of thoracic organs became a clinica
l reality, many advances have been made in preoperative donor management, p
rocurement, and preservation techniques. This article summarizes the state
of the art in heart and lung preservation and review some of the areas of c
urrent research that may lead to improvements in preservation techniques in
the future.