*Purpose: Lung Transplantation(LT)has been demonstrated as the only effective therapy for patients with end-stage lung diseases. This study aimed to summarize and analyze the data of LT development in mainland China (excluding Hongkong, Macao and Taiwan) during2015-2018.

*Methods: We retrospectively collected and analyzed the data from those patients registered by each LT center in CLuTR from January 1, 2015 to December 31, 2018. Key data were reported from registry with distribution of medical institutions for lung transplantation, donor and recipient characteristics, indications, transplant types, outcomes and survival.

*Results: Distribution of medical institutions for LT By the end of 2018, 32 medical institutions in China have obtained qualifications for LT. These institutions cover 20 provinces and are mainly distributed in the east and north of China.In 2018, LT was performed in 15 centers. The top three centers by the number of operations were Wuxi People’s Hospital (37.2%), China-Japan Friendship Hospital (26.5%), and the First Affiliated Hospital of Guangzhou Medical University (16.1%). Donor and recipient characteristics The average age of LT recipients in China was 54.9±12.8 years during 2015-2018, and the proportion of recipients aged above 60 years was significantly higher than that reported by ISHLT (46.6% versus 38.8%). Indications During 2015-2018, the primary diseases in LT recipients in China mainly included idiopathic interstitial pneumonia (39.0%), chronic obstructive pulmonary disease (23.0%), non-idiopathic interstitial pneumonia (13.2%), and pneumoconiosis (9.2%). The proportion of idiopathic and non-idiopathic interstitial pneumonias is significantly higher in China than that in foreign countries (39.0% versus 25.7%). Transplant types There were relatively large differences between the single-lung and double-lung transplantations reported by China during 2015-2018 (57.6% and 42.4%). Early postoperative complications Infection (68.2%), acute rejection (17.4%), renal insufficiency (16.0%), primary lung graft failure (15.6%), diabetes (9.2%), bronchopleural fistula (6.4%), and bronchial anastomotic lesions (5.9%) are the main early complications reported after lung transplantation in China. Status at discharge The survival rate of LT recipients before discharge was 73.1% during 2015-2018. The survival rates at discharge in 2015, 2016, 2017 and 2018 were 76.0%, 76.5%, 72.8% and 70.4%, respectively, thereby showing a downward trend over the years.

*Conclusions: As compared with the international cases, the cases of lung transplantation in China have the features of many old recipients with critical illness, pulmonary fibrosis or occupational pneumoconiosis, difficult operation, and long cold ischemia time of deceased donor lungs. As compared with the international level, lung transplantation techniques in China still have a lot of room for improvement.

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