After lung transplantation, ischemia/reperfusion injury occurs primarily due to mechanisms that increase pulmonary vascular permeability and cause alveolar epithelial cell damage.¹-³ Apoptosis represents the process of programmed cell death. At present, little has been described about the relation between the preservation/reperfusion injury and the induction of apoptosis. The aims of this study were to examine the ultrastructural changes during apoptosis in lung parenchymal cells during preservation and reperfusion in canine lung transplantation using electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) technique.