Lung transplantation has poor long-term survival relative to other solid organ transplants. This can be largely attributed to higher rates of chronic lung allograft dysfunction and infection following transplant. The lungs are non-sterile and a lung microbiome is present primarily through microaspiration of upper respiratory tract microbiota. Patients who have undergone lung transplantation exhibit a dysbiotic lung microbiome relative to healthy patients. It is proposed that the saliva from the upper respiratory tract of healthy volunteers can be nebulized to produce aerosolized microbe-containing saliva droplets. Lung transplant patients can inhale nebulized saliva from healthy volunteers to help establish a healthy lung microbiome and prevent chronic infection following their transplant. This concept is analogous to the well-established use of a fecal transplant from healthy volunteers in patients with a dysbiotic colon.