Ex-vivo lung perfusion (EVLP) may improve donor lung utilization but requires significant infrastructure and expertise. Centralized EVLP facilities may mitigate these requirements. From the United Network for Organ Sharing database, we identified 345 adults undergoing isolated, first-time lung transplantation using donor lungs perfused by static EVLP (03/01/2018-12/31/2022). Recipients of lungs perfused at centralized EVLP facilities (n=165) were compared to recipients of lungs perfused at individual transplant centers (n=180). Propensity score matching was used to create balanced groups for comparison. Centralized EVLP facilities were increasingly utilized from 2018 to 2022 (35.3 vs. 55.8%, p=0.04) and were more likely used when the annual center volume of EVLP lung transplants was low. Compared to allografts placed on EVLP at individual transplant centers, those placed on EVLP at centralized facilities had longer median ischemic time (11.3 vs. 9.6 hours, p<0.001) and were less likely to come from donation after circulatory death donors (25.4 vs. 39.5%, p=0.003) or be used for double lung transplant (73.3 vs. 83.9%, p=0.02). In 102 well-matched recipients, 2-year survival was equivalent between those receiving allografts perfused at centralized facilities (77.9% [95% CI 68.0-85.1%]) versus individual transplant centers (77.7% [95% CI 67.8-84.9%], p=0.90). Multivariable Cox regression analysis also showed equivalent 2-year survival (adjusted hazard ratio 1.02, 95% CI 0.57-1.84, p=0.95). Transplanting lung allografts that underwent static EVLP at centralized facilities had similar outcomes compared to transplanting lungs perfused at individual transplant centers. The centralized model of clinical EVLP can potentially improve access to EVLP.