Aim: Feasibility and reliability assessment of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Pulmonary Graft (PG) on Telemedicine Systems, in Lung Transplant (LT). Material and Methods: Sensitivity-specificity by simulating TRE of PG on 15 MR thoracic images by two radiologists and TPE by 20 specialists based on a total of 100 human PG digital images. Results: Integration of TRE and TPE of PG showed an accuracy of 94.1% for hematomas and 97.1% for neoplastic identification. Conclusion: Integrated TRE and TPE of PG is feasible and reliable for reducing the rate of injured and diseased PG in LT.