Successful lung transplantation depends on careful donor selection and meticulous procurement, preservation, and transport. While donation after brain death (DBD) remains the standard, donation after circulatory death (DCD) has emerged as a viable alternative, with comparable results in experienced centers. Procurement protocols involving lung-protective ventilation, hormonal resuscitation, and judicious fluid management are critical to preserving graft function. Advances in organ preservation, particularly static cold storage at 10 °C, have extended safe ischemic times without compromising outcomes. Donor-specific factors, including age, smoking history, diabetes, and infection risk, continue to influence both graft viability and recipient survival.