Abstract
Orthotopic lung transplantation in rats serves as a pivotal platform for exploring long-term allograft outcomes, yet technical complexity has limited its widespread application. Here, we present a refined surgical model that combines structured intraoperative modifications with tailored mechanical ventilation strategies to ensure procedural consistency and biologic fidelity. Key interventions-such as a custom leak-proof endotracheal tube, a temporally controlled reperfusion maneuver, and an optimized anastomotic sequence-collectively addressed critical challenges including airway obstruction, graft impaired perfusion, and venous fragility. The protocol demonstrated a high procedural success rate and reproducible long-term survival, with histopathological analysis confirming progressive chronic remodeling and diminished acute rejection. Importantly, the technique demonstrated features that facilitate rapid acquisition, supported by a short learning curve, and was implemented using widely accessible clinical-grade materials. Together, these attributes establish a robust and scalable platform for investigating chronic lung allograft dysfunction and other long-term immunologic phenomena.