A Decade of Lung Transplantation in China (2015-2024): Driving Quality Improvement and Scale Expansion Through Management Systems.

Since organ donation after citizen death became the sole legal source in 2015, lung transplantation (LTx) in China has undergone a systematic transformation, shifting from numerical scarcity to scale expansion and from technical exploration to sustained improvement in quality. From a management perspective, this article provides a comprehensive review of the development of LTx in China between 2015 and 2024, demonstrating that its central achievement has been the establishment of an integrated management system that combines national top-level policy design, standardized and homogeneous training, multidisciplinary collaboration, standardized clinical pathways, and rigorous quality assessment. Supported by a mechanism based on data-driven decision making, standard-guided implementation, and closed-loop management, this system has effectively ensured quality homogeneity and controllable risk during the dissemination of advanced transplantation techniques. Over the past decade, the number of hospitals performing LTx increased from 9 to 45, annual procedure volume rose from 118 to 925 cases, and the cumulative total of completed LTx was 5483. During the same period, 30-day survival improved from 78.5% to 85.3%. This system-oriented management model provides an important reference for the global community, particularly for developing countries facing challenges related to resource imbalance, by demonstrating how institutional innovation can facilitate the safe and efficient dissemination of highly complex medical technologies.