| Ventilation | Tidal volume: 6 to 10 mL/kg FiO2: 50 percent PEEP: 5 to 10 cm H2O |
| Anticoagulation (once lungs and heart exposed) | Heparin 250 to 300 units per kg, intravenously |
| Prostaglandin pretreatment | Prostaglandin E1 (PGE1, Alprostadil) 500 mcg via main pulmonary artery |
| Flush solution | Low potassium dextran (Perfadex) |
| Temperature | 4 to 8°C |
| Antegrade flush | Infuse 50 to 75 mL/kg of flush solution into main pulmonary artery. Hang preservation solution 30 cm above level of donor and let flush by gravity. Do not use pressurized bags. |
| Cardioplegia solution (only when heart is used for transplantation) | Infuse retrograde from aorta |
| Topical cooling | Iced saline slush added to pleural and pericardial spaces |
| Retrograde flush, after removal of heart | Infuse 250 mL of flush solution into each pulmonary vein orifice and vent at pulmonary artery opening |
