Level A Evidence

6 Treatment Options Available

Lung Transplant

Q: Is single or double lung transplant better?

Bilateral (double) lung transplant is preferred for most conditions due to better survival and lower infection risk. Single lung may be considered for selected COPD patients or due to donor constraints.

Q: Can cystic fibrosis patients receive lung transplants?

Yes, CF is a common indication for lung transplant. Bilateral transplant is required to remove all infected tissue. Outcomes for CF patients are generally good with appropriate selection.

Q: What is primary graft dysfunction?

PGD is acute lung injury in the first 72 hours after transplant, affecting 10-25% of recipients. It ranges from mild to severe and is managed with supportive care including ECMO if needed.

Q: How is rejection monitored after lung transplant?

Surveillance includes regular bronchoscopies with biopsies (frequently in first year), pulmonary function tests, and chest imaging. Patients also monitor for symptoms like decreased exercise tolerance or new cough.

Single and double lung transplantation for end-stage pulmonary disease

Lung transplantation offers hope for patients with end-stage lung disease when all other treatments have failed. Chinese lung transplant centers perform both single and bilateral (double) lung transplants, with bilateral becoming the preferred option for most conditions. Advanced techniques including ECMO bridging, ex-vivo lung perfusion (EVLP), and sophisticated immunosuppression protocols have improved outcomes significantly.

JCI Accredited

90%+ 1-Year Survival

Living & Deceased Donor

Condition Overview

Conditions We Treat

COPD/EmphysemaIdiopathic Pulmonary FibrosisCystic FibrosisPulmonary HypertensionBronchiectasisAlpha-1 Antitrypsin DeficiencyInterstitial Lung Disease

Core Technologies

Bilateral sequential technique • ECMO bridging • Ex-vivo lung perfusion (EVLP) • Clamshell incision • Video-assisted techniques • Lobar transplantation • Size reduction techniques

ผู้สมัครที่เหมาะสม

•End-stage lung disease (FEV1 or FVC <30%)
•High oxygen requirements or ventilator dependence
•No other major organ failure
•No active malignancy or infection
•BMI 18-30, age typically <65
•Strong social support and compliance history

Bilateral transplant preferred for septic lung diseases and pulmonary hypertension

พิจารณาทางเลือกในประเทศ

•Patients requiring very complex re-transplants
•Those on long-term ECMO with associated complications
•Multi-organ failure requiring combined transplant
•Patients with extensive chest wall abnormalities

Evidence: Bilateral lung transplant demonstrates 85-90% 1-year survival, 55-60% 5-year survival. Single lung transplant slightly lower survival but suitable for selected patients. Chinese centers report outcomes approaching international benchmarks.

Treatment Options

Bilateral (Double) Lung Transplant

ศัลยกรรม

เหมาะสำหรับ:Most end-stage lung diseases, especially septic lungs or pulmonary hypertension

เทคโนโลยี:Bilateral sequential technique via clamshell incision

ข้อดี:Better long-term survival, lower infection risk

Surgery 6-10 hours, ICU 7-14 daysFrom $120,000

Preferred procedure for most indications

Single Lung Transplant

ศัลยกรรม

เหมาะสำหรับ:Selected COPD/emphysema, elderly patients

เทคโนโลยี:Single lung replacement via thoracotomy or sternotomy

ข้อดี:Shorter procedure, may expand donor pool

Surgery 4-6 hours, ICU 5-10 daysFrom $100,000

Selected cases only

ECMO Bridge to Transplant

ศัลยกรรม

เหมาะสำหรับ:Critically ill, respiratory failure awaiting transplant

เทคโนโลยี:Veno-venous ECMO for respiratory support

ข้อดี:Maintains candidacy for critically ill

Days to weeks of supportFrom $150,000 total

Specialized critical care

Ex-Vivo Lung Perfusion (EVLP)

ศัลยกรรม

เหมาะสำหรับ:Marginal donor lungs requiring assessment/reconditioning

เทคโนโลยี:Lungs perfused outside body with specialized solution

ข้อดี:Expands donor pool, improves organ utilization

Added to transplant procedureFrom $30,000 additional

Limited specialized availability

Lobar Lung Transplant

ศัลยกรรม

เหมาะสำหรับ:Size-mismatched recipients (small adults or large children)

เทคโนโลยี:Transplant of single lobe from deceased donor

ข้อดี:Makes transplant possible for size-mismatched pairs

Similar to standard transplantFrom $120,000

Specialized technique

Post-Transplant Pulmonary Care

การแพทย์

เหมาะสำหรับ:All lung transplant recipients

เทคโนโลยี:Immunosuppression, bronchoscopic surveillance, rehab

ข้อดี:Essential for graft survival

Lifelong surveillanceFrom $800/month

Comprehensive programs

การเปรียบเทียบค่าใช้จ่าย

Bilateral Lung Transplant (Including 1-Year Follow-up)

US Transplant Center$1,400,000

UK NHS/Private$300,000

MediLink China$150,000

Save 89% vs US • Includes: surgery, hospital stay, ICU, ECMO if needed, immunosuppression, pulmonary rehabilitation, 1-year follow-up.

คำนวณต้นทุน

ขั้นตอนการรักษา

Evaluation• 1-2 weeks

Comprehensive pulmonary testing
High-resolution CT chest
Right heart catheterization
Six-minute walk test
Nutritional and psychosocial assessment

Transplant Surgery• Week of surgery

Organ procurement coordination
Bilateral lung transplant (6-10 hours)
ICU recovery with ventilator support
Early bronchoscopic assessment
Immunosuppression and infection prophylaxis

Rehabilitation• Months 1-6

Intensive pulmonary rehabilitation
Frequent bronchoscopies with biopsies
Rejection surveillance
Infection monitoring and prophylaxis
Gradual physical conditioning

Clinical Outcomes

1-Year Survival

85-90%

bilateral

5-Year Survival

55-60%

bilateral

FEV1 Improvement

60-80%

predicted

Bronchiolitis Rate

30-50%

at 5 years

คำถามที่พบบ่อย

Is single or double lung transplant better?

Bilateral (double) lung transplant is preferred for most conditions due to better survival and lower infection risk. Single lung may be considered for selected COPD patients or due to donor constraints.

Can cystic fibrosis patients receive lung transplants?

Yes, CF is a common indication for lung transplant. Bilateral transplant is required to remove all infected tissue. Outcomes for CF patients are generally good with appropriate selection.

What is primary graft dysfunction?

PGD is acute lung injury in the first 72 hours after transplant, affecting 10-25% of recipients. It ranges from mild to severe and is managed with supportive care including ECMO if needed.

How is rejection monitored after lung transplant?

Surveillance includes regular bronchoscopies with biopsies (frequently in first year), pulmonary function tests, and chest imaging. Patients also monitor for symptoms like decreased exercise tolerance or new cough.

Important Information

Organ transplantation involves complex medical, ethical, and legal considerations. China operates a voluntary citizen organ donation system based on deceased donation after death, established in 2015. Eligibility for foreign patients depends on multiple factors including medical urgency, donor availability, and current regulations. Please contact us for current eligibility criteria and program availability.

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