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Background Patterns of use of older donor lungs within this previously underutilized donor population are poorly characterized. We examined factors associated with the use of older donor lung allografts and factors associated with survival in recipients of these lungs. Methods Adult donors in the UNOS registry who donated ≥1 organ for transplantation between 2006-2018 were analyzed and stratified into older (age55) and younger (age≤55) cohorts. Multivariable logistic and Cox regression were used to identify factors associated with