One of China's Premier Lung Transplantation Centers
The Lung Transplantation Program at Shanghai Pulmonary Hospital — affiliated with Tongji University — is one of China's most distinguished and highest-volume lung transplantation centers, with a national reputation for excellence in single and bilateral lung transplantation, ECMO-bridged transplantation, re-transplantation, and the management of complex end-stage lung disease. As China's premier dedicated pulmonary specialty hospital, the lung transplantation program benefits from unparalleled integration with respiratory medicine, thoracic surgery, pulmonary oncology, and critical care — offering international patients a uniquely comprehensive transplant experience. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients throughout their lung transplantation journey at Shanghai Pulmonary Hospital.
About the Program
The lung transplantation program is a national key clinical specialty operating dedicated transplant wards with HEPA-filtered isolation rooms, a transplant ICU, a lung transplant outpatient clinic, a pre-transplant evaluation program, a post-transplant surveillance program, a pulmonary rehabilitation program, and works in close collaboration with respiratory medicine, thoracic surgery, critical care, infectious disease, and immunology through a fully integrated multidisciplinary transplant team.
Faculty members publish regularly in leading transplantation journals including Journal of Heart and Lung Transplantation, American Journal of Transplantation, Transplantation, European Journal of Cardio-Thoracic Surgery, and Chest.
Indications for Lung Transplantation
Obstructive Lung Disease
- COPD/Emphysema — BODE index ≥7; FEV1 <20% predicted; hypercapnia; pulmonary hypertension; frequent exacerbations; bilateral lung transplantation preferred for COPD; one of China's most experienced COPD transplant programs
- Alpha-1 Antitrypsin Deficiency (AATD) — Bilateral lung transplantation; augmentation therapy post-transplant; genetic counseling
- Lymphangioleiomyomatosis (LAM) — FEV1 or DLCO <30% predicted; bilateral lung transplantation; sirolimus post-transplant
Fibrotic Lung Disease
- Idiopathic Pulmonary Fibrosis (IPF) — Most common indication; DLCO <39%; 6MWT desaturation; FVC decline >10% in 6 months; bilateral lung transplantation preferred; urgent listing for acute exacerbation of IPF; one of China's most experienced IPF transplant programs
- Non-IPF Progressive Pulmonary Fibrosis — SSc-ILD; RA-ILD; NSIP; HP; unclassifiable ILD; bilateral lung transplantation
- Sarcoidosis — Stage IV fibrotic sarcoidosis; bilateral lung transplantation; cardiac sarcoidosis evaluation
Pulmonary Vascular Disease
- Pulmonary Arterial Hypertension (PAH) — WHO functional class III-IV despite maximal medical therapy; 6MWT <350m; cardiac index <2L/min/m²; bilateral lung transplantation; heart-lung transplantation for Eisenmenger syndrome with complex cardiac anatomy
- CTEPH — Inoperable CTEPH not responding to BPA and riociguat; bilateral lung transplantation
Suppurative Lung Disease
- Cystic Fibrosis (CF) — FEV1 <30% predicted; rapid decline; 6MWT <400m; bilateral lung transplantation mandatory; CFTR modulator therapy (elexacaftor/tezacaftor/ivacaftor — Trikafta) may delay transplant need; post-transplant CFTR modulator continuation
- Bronchiectasis — Non-CF bronchiectasis with end-stage disease; bilateral lung transplantation; pre-transplant pathogen optimization
- NTM Lung Disease — Selected cases of end-stage NTM lung disease; bilateral lung transplantation; pre-transplant NTM eradication attempts
Pre-Transplant Evaluation
- Pulmonary Assessment — Pulmonary function tests (spirometry, DLCO, lung volumes); 6-minute walk test; CT chest; V/Q scan; right heart catheterization; echocardiography
- Cardiac Assessment — Echocardiography; coronary angiography for patients >50 years; cardiac MRI for sarcoidosis; stress testing
- Infectious Disease Screening — CMV, EBV, HSV, VZV, HIV, HBV, HCV serology; IGRA for LTBI; fungal serology; sputum cultures; Pseudomonas and Burkholderia cepacia complex for CF/bronchiectasis
- Immunological Assessment — ABO blood group; HLA typing; PRA (panel reactive antibody); virtual crossmatch; DSA screening
- Nutritional Assessment — BMI optimization; malnutrition correction; obesity management; coordination with clinical nutrition
- Psychosocial Assessment — Psychiatric evaluation; social support; medication adherence assessment; smoking cessation verification
- Rehabilitation Assessment — Pre-transplant pulmonary rehabilitation; exercise capacity optimization; prehabilitation
Transplant Surgery
Surgical Approaches
- Bilateral Sequential Lung Transplantation (BSLT) — Most common procedure; clamshell or bilateral anterolateral thoracotomy; sequential implantation; one of China's highest-volume BSLT programs
- Single Lung Transplantation (SLT) — For selected COPD and IPF patients; posterolateral thoracotomy; shorter operative time; preserves donor organ for two recipients
- Heart-Lung Transplantation — For Eisenmenger syndrome with complex cardiac anatomy; PAH with severe RV failure; median sternotomy; coordination with cardiac surgery
- Re-Transplantation — For chronic lung allograft dysfunction (CLAD); primary graft dysfunction (PGD); one of China's most experienced re-transplantation programs
Intraoperative Support
- ECMO — Intraoperative VA-ECMO or VV-ECMO support; ECMO as bridge to transplantation; awake ECMO bridge; one of China's most experienced ECMO-bridged transplant programs
- Cardiopulmonary Bypass (CPB) — For heart-lung transplantation and selected complex cases
- Ex Vivo Lung Perfusion (EVLP) — Assessment and reconditioning of marginal donor lungs; Toronto protocol; expanding the donor pool
Post-Transplant Management
Immunosuppression
- Standard Triple Therapy — Tacrolimus + mycophenolate + corticosteroids; tacrolimus target levels; mycophenolate dose optimization; steroid minimization
- Induction Therapy — Basiliximab; anti-thymocyte globulin (ATG) for high-risk patients
- mTOR Inhibitors — Everolimus or sirolimus substitution for calcineurin inhibitor nephrotoxicity; anti-proliferative effect for CLAD
- Belatacept — Investigational in lung transplantation; costimulation blockade
Primary Graft Dysfunction (PGD)
- ISHLT PGD grading; lung-protective ventilation; prone positioning; inhaled nitric oxide; ECMO for severe PGD; one of China's most experienced PGD management programs
Rejection
- Acute Cellular Rejection (ACR) — Pulse corticosteroids; ATG for steroid-refractory ACR; surveillance bronchoscopy with BAL and transbronchial biopsy
- Antibody-Mediated Rejection (AMR) — IVIG + rituximab; plasmapheresis; eculizumab for severe AMR; DSA monitoring
- Chronic Lung Allograft Dysfunction (CLAD) — BOS (bronchiolitis obliterans syndrome): azithromycin; montelukast; pirfenidone; re-transplantation for selected patients; RAS (restrictive allograft syndrome): nintedanib; re-transplantation
Infectious Complications
- CMV — Valganciclovir prophylaxis; pre-emptive therapy; ganciclovir for CMV disease; maribavir for refractory CMV
- Aspergillus — Voriconazole or inhaled amphotericin B prophylaxis; treatment of invasive aspergillosis; isavuconazole; olorofim for azole-resistant Aspergillus
- PCP — TMP-SMX prophylaxis; atovaquone for intolerant patients
- Bacterial Infections — Pseudomonas aeruginosa; MRSA; MDR gram-negative; culture-directed antibiotics; inhaled antibiotics for chronic airway colonization
Post-Transplant Surveillance
- Surveillance bronchoscopy with BAL and transbronchial biopsy at 1, 3, 6, 12 months; spirometry monitoring; CT chest; DSA monitoring; tacrolimus TDM; renal function; bone density; skin cancer surveillance
ECMO Bridge to Transplantation
Shanghai Pulmonary Hospital's ECMO bridge to transplantation program is one of China's most experienced:
- VV-ECMO Bridge — For hypoxemic respiratory failure; awake ambulatory ECMO; rehabilitation on ECMO; one of China's most experienced awake ECMO bridge programs
- VA-ECMO Bridge — For PAH with severe RV failure; cardiogenic shock; combined cardiorespiratory failure
- Awake Ambulatory ECMO — Avoids mechanical ventilation; preserves muscle mass; allows rehabilitation; improves post-transplant outcomes
Why International Patients Choose Shanghai Pulmonary Hospital Lung Transplantation
- One of China's Highest-Volume Programs — Unparalleled experience; comprehensive pre- and post-transplant care under one roof
- Awake ECMO Bridge — One of China's most experienced awake ambulatory ECMO bridge programs; avoids mechanical ventilation; preserves rehabilitation capacity
- EVLP — Ex vivo lung perfusion for marginal donor lungs; expanding the donor pool
- Re-Transplantation — One of China's most experienced re-transplantation programs for CLAD
- IPF Urgent Listing — Rapid listing and transplantation for acute exacerbation of IPF
- Cost-Effectiveness — World-class lung transplantation at significantly lower cost than equivalent treatment in Western countries
The CMCS Patient Journey
- Initial Inquiry — Share your lung diagnosis, pulmonary function tests, 6MWT results, CT chest, right heart catheterization data, and current medications with CMCS.
- Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
- Transplant Evaluation Coordination — We coordinate your comprehensive pre-transplant evaluation including all required assessments and specialist consultations.
- Listing Decision — We facilitate the transplant team's listing decision and lung allocation score calculation.
- Priority Scheduling — We secure evaluation appointments with minimal waiting time.
- Travel & Logistics — Assistance with visa invitation letters, long-stay accommodation near Shanghai Pulmonary Hospital, and Shanghai airport transfers; guidance on extended stay planning for transplant waiting period.
- Transplant & Recovery Coordination — Full coordination of transplant admission, surgery, ICU care, and post-transplant rehabilitation.
- Long-Term Follow-Up — Post-transplant report translation, immunosuppression guidance, surveillance bronchoscopy coordination, and remote follow-up after you return home.
Book a Consultation
If you have end-stage IPF, COPD, PAH, cystic fibrosis, bronchiectasis, or any end-stage lung disease requiring transplantation evaluation — CMCS can arrange a specialist consultation with Shanghai Pulmonary Hospital's lung transplantation team.
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