Background: The purpose of this investigation is to evaluate the effect of prone ventilation for 16 hours or greater in potential lung donors with death by neurological criteria on lung transplantation outcomes. Methods: Data was derived from the Midwest Transplant Network from January 2005 to November 2020. Prolonged proning began in January 2019. The primary endpoints were change in PAO2:FiO2 ratio, lungs transplanted per year, and percentage of lungs transplanted. Patients were divided into three groups: not prone, 360-degree rotational positioning, and prone for 16 hours or greater. Results: The change in PFR was significantly higher (p-value < 0.001) with rotational positioning. Despite this, the average number of total lungs transplanted per year was significantly higher (p-value < 0.000) with a 16 hour or more prone position. A statistically significant increase was seen in lung transplantations after implementing a 16-plus hour prone ventilation protocol. Despite the greatest change in PFR seen in the rotational group, more lungs were transplanted in the 16-plus hour prone ventilation group. Conclusion: These findings suggest that prone ventilation for 16 hours or more may improve lung transplantation rates despite smaller changes in oxygenation indices compared to rotational positioning. This protocol may offer a valuable strategy to expand the donor pool and increase the number of lungs successfully transplanted.