We report the case of a 32-year-old female patient with primary pulmonary hypertension who received a lung transplant from a donor who, unbeknownst to the medical staff, had pulmonary sarcoidosis diagnosed by lung biopsy 16 months earlier. After 16 months of follow-up, our patient did not show any histologic, radiologic, or clinical evidence of pulmonary sarcoidosis involving the transplanted lung. We reviewed the transplant experience involving donors or recipients with known sarcoidosis, and the available data suggest that normal organs transplanted into recipients with preexisting sarcoidosis are likely to develop sarcoid granulomas, whereas organs from donors with known sarcoidosis given to a "normal" recipient do not appear to develop significant or progressive disease. Although the available data in this regard are limited, we do believe that, on the basis of current information, sarcoidosis cannot be considered a priori to be an absolute contraindication to organ donation.