*Purpose: The treatment of patients with end-stage idiopathic pulmonary fibrosis (IPF) and lung cancer (LC) is a difficult task, and it remains questionable whether LC should be treated. Lung transplantation is an effective treatment for IPF. However, little knowledge indicates the effectiveness of the treatment for IPF-LC. The purpose of this study was to retrospectively evaluate the safety and clinical outcomes of lung transplantation for patients with advanced IPF-LC .

*Methods: A total of eight patients with advanced IPF-LC were enrolled in this retrospective study. The diagnosis of IPF-LC is based on pathological confirmation. Preoperative evaluation mainly includes high-resolution computed tomography of the chest (HRCT), arterial blood gas analysis, pulmonary function test, 6-minute walk test, cardiac echocardiography, skull CT, abdominal CT and positron emission tomography and computed tomography.

*Results: Of these 8 patients,7 were over 60 years old, and 6 had a history of smoking. Coughing in 7 cases, spitting in 5 cases, and all the cases had dyspnea. There were 3 cases of squamous cell carcinoma, 3 cases of adenocarcinoma, 1 case of small cell lung cancer, and 1 case of carcinoid. 4 patients received single lung transplants and 4 received double lung transplants. There were no obvious intraoperative complications, and 7 patients needed intraoperative extracorporeal membrane oxygenation (ECMO) support. Two cases were severely infected, one died within 30 days after operation. Another one died of severe arrhythmia on the 4th post-operation day. The one-year survival rate after transplantation is 75%. So far there have been no signs of tumor recurrence found.

*Conclusions: After strict preoperative assessment of lung transplantation, early lung cancer with end-stage IPF can be treated with lung transplantation. However, strict screening must be performed, and patients must be informed of the prognosis and the possibility of tumor regeneration.

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