<h3>Purpose</h3> To address the shortage of pediatric donor lungs the French lung allocation system assigns priority status to pediatric candidates. Consequently, pediatric candidates frequently receive organ from adult donors. An association between donor age and posttransplant mortality has been shown in adult lung recipients. This study aimed to evaluate the effect of donor age on posttransplant mortality in pediatric lung recipients <h3>Methods</h3> All candidates registered on the national waiting list before 18 years old between January, 1<sup>st</sup> 2010 and December 31<sup>st</sup> 2020 who underwent transplantation were included in this cohort study using the national registry Cristal. Recipient characteristics at transplant in addition to donor characteristics were analyzed. 1-year posttransplant survival was estimated by the Kaplan-Meier method. Cubic spline model was used to evaluate the association between donor age as continuous variable and 1-year posttransplant mortality. <h3>Results</h3> Of the 121 transplant recipients (55 males, 11+ years n=110, cystic fibrosis n=76, pulmonary fibrosis n=28, pulmonary hypertension n=14, bronchiectasis n=3) 21 were on extracorporeal membrane oxygenation (ECMO), 4 on mechanical ventilation without ECMO at transplant. Among donors, 76 were female, cerebrovascular accident and head trauma were the cause of death in 60 and 35 respectively, 17 had PaO2/FiO2 ratio <350 mmHg, 56 were CMV-positive, 40 had cardiopulmonary resuscitation and 96 (79%) were >17 years old. One-year posttransplant survival was 82%. Pretransplant ECMO and mechanical ventilation without ECMO, and donor-recipient height ratio >1.2 were associated with posttransplant mortality. Donor age was not associated with hazard ratio for 1-year mortality (Figure). <h3>Conclusion</h3> Allocation of adult donor lungs to elective and urgent pediatric candidates through pediatric priority status can address the shortage of pediatric donor organs without affecting posttransplant outcomes.