*Purpose: The pneumoconiosis are parenchymal lung diseases that arise from inhalation of dusts. And lung transplantation is an effective method for the treatment of end-stage lung disease. Here, we will introduce the experience of lung transplantation for pneumoconiosis in China.

*Methods: We conducted a retrospective review of pneumoconiosispatients who underwent LT at Wuxi people’s hospital and the first affiliated hospital of Zhejiang university between 2015 and 2019. Pre- and post-transplant data were assessed.

*Results: 63 patients with pneumoconiosis underwent LT. 20 (31.7%) patients underwent double-LT. The mean interval between pneumoconiosis diagnosis and transplant was7.1±5.8 years and the mean FEV1 before LT was 0.8±0.3 L(only 23 patients were able to complete before operation ). 9 patients suffered from tuberculosis and 24 patients suffered from recurring pneumothorax before operation. 29 patients had pulmonary artery hypertension. Patients were followed up for mean 14.6 months. The main complications after operation: 6 cases of severe primary graft dysfunction, 2 cases of acute rejection, 3 cases of bronchoconstriction, and 33 cases of early post-operative pulmonary infection. There were 13 deaths during the study and both1-year and 3-year survival rates were 79.4%.

*Conclusions: Lung transplantation is an effective method for the treatment of end-stage pneumoconiosis. However, there is currently no uniform timing criteria for pneumoconiosis candidates in the world. Moreover, pneumoconiosis has its unique characteristics in evaluation and preoperative management , it is quite different from common pulmonary interstitial fibrosis. With the accumulation of experience, there must be a deeper understanding of such diseases.

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