Historically, most of experimental work to seek for the optimal lung inflation techniques during lung preservation was performed in the late 1990s. Currently clinical lung preservation protocol has been more standardized; however, the optimal lung inflation techniques under the current lung preservation setting remain to be defined while those techniques play a pivotal role in the optimal lung preservation.Lewis rat lungs were perfused with and stored in cold Perfadex for 6 hours at different levels of lung inflation defined by total lung capacity (25%, 50%, 75% or 100% of total lung capacity (TLC)) (Fig. 1A). Then orthotopic left lung transplantation using cuff techniques was performed in syngenic Lewis rats. Two hours after reperfusion, posttransplant allograft function, pro-inflammatory and lung surfactant profiles were evaluated and compared among the groups.Lungs with 75% or 100% TLC inflation showed a significantly better oxygenation in blood gas than 25% and 50% inflated lungs (Fig 1B). Lungs with 75% or 100% TLC exhibited attenuated serum TNF-α, IL-1β, ICAM-1 mRNA levels as compared to those with the deflated lungs, suggesting reduced ischemic reperfusion injury. In addition, transmission electron microscopy investigation confirmed better preserved lung surfactants in the alveolar space in the lungs with 75% or 100% TLC.Lungs with 75% or 100% TLC inflation during preservation appear to be more beneficial with better posttransplant allograft function through attenuated reperfusion injury and better preserved lung surfactants.