[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"end-stage-lung-disease\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:end-stage-lung-disease":25},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,5,0,[8,41,72,92,110],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":4,"eligibilityCriteria":14,"healthyVolunteers":11,"sex":15,"minAge":16,"maxAge":17,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":4,"briefSummary":22,"conditions":23,"keywords":27,"overallStatus":28,"whyStopped":4,"lastUpdateSubmitDate":29,"lastUpdatePostDateStruct":30,"startDateStruct":33,"completionDateStruct":35,"leadSponsor":37,"locationsCount":40},"100632645","graft-20-a-multimodal-prospective-approach-to-define-the-mechanisms-and-clinical-features-of-acute-and-chronic-rejection-in-lung-transplantation-100632645",false,"NCT07516379","GRAfT 2.0. A Multimodal Prospective Approach to Define the Mechanisms and Clinical Features of Acute and Chronic Rejection in Lung Transplantation","* INCLUSION CRITERIA:\n\nIn order to be eligible to participate in this study, an individual must meet all of the following criteria:\n\n1. Stated willingness to comply with study procedures and availability for the duration of the study.\n2. Male or female, aged 18 - 75 years of age.\n3. Have progressive lung disease or undergone or being evaluated for lung transplantation.\n4. Ability of subjects to understand the informed consent document.\n\nEXCLUSION CRITERIA:\n\nAn individual who meets any of the following criteria will be excluded from participation in this study:\n\n1\\. Pregnancy or lactation","ALL","18 Years","75 Years",{"count":19,"type":20},100,"ESTIMATED","OBSERVATIONAL","Background:\n\nLung transplants can save lives, but the procedure has risks. Some people develop donor-specific antibodies (DSA) after the procedure-that is, their bodies create proteins that treat the new lungs as foreign and mount an immune response against them. This is called rejection. But not everyone who has a transplant develops DSA, and not everyone who has DSA develops rejection. Researchers want to understand why.\n\nObjective:\n\nTo collect data to try to find out why some people develop rejection after lung transplants while others do not.\n\nEligibility:\n\nPeople aged 18 to 75 years who have progressive lung disease or undergone or may undergo a lung transplant.\n\nDesign:\n\nParticipants will have clinic visits every 3 to 6 months for up to 4 years. Some visits might require an overnight stay.\n\nEach visit will include multiple tests and procedures:\n\nPhysical exam with blood and urine tests. Some blood will be used for genetic testing.\n\nImaging scans. Participants will have 2 types of scan to get images of their lungs. For one, they will have a contrast agent given through a tube inserted into a vein.\n\nSix-minute walk test. Participants will walk back and forth in a hallway at their own pace. Researchers will check on how their body responds.\n\nLung function test. Participants will breathe into a tube connected to a machine.\n\nTwo other tests are optional:\n\nBronchoscopy with washings (lavage). A long tube with a light will be threaded down through the participant s nose or mouth and into their lungs.\n\nEndomicroscopy. During the bronchoscopy a tiny camera may be used to take pictures inside the lungs.\n\n...",[24,25,26],"Lung Transplant","End Stage Lung Disease","Rejection",[24,26],"RECRUITING","2026-06-10",{"date":31,"type":32},"2026-06-11","ACTUAL",{"date":34,"type":32},"2026-05-11",{"date":36,"type":20},"2032-03-27",{"name":38,"class":39},"National Heart, Lung, and Blood Institute (NHLBI)","NIH",1,{"id":42,"slug":43,"hasResults":11,"nctId":44,"briefTitle":45,"officialTitle":46,"acronym":4,"eligibilityCriteria":47,"healthyVolunteers":11,"sex":15,"minAge":16,"maxAge":48,"enrollmentInfo":49,"targetDuration":4,"studyType":51,"phases":52,"briefSummary":54,"conditions":55,"keywords":57,"overallStatus":61,"whyStopped":4,"lastUpdateSubmitDate":62,"lastUpdatePostDateStruct":63,"startDateStruct":65,"completionDateStruct":67,"leadSponsor":69,"locationsCount":4},"100622511","perioperative-recovery-outcomes-with-a-spontaneous-breathing-strategy-in-severely-underweight-lung-transplant-recipients-100622511","NCT07384572","Perioperative Recovery Outcomes With a Spontaneous Breathing Strategy in Severely Underweight Lung Transplant Recipients","Evaluation of Perioperative Recovery Outcomes of a Spontaneous Breathing-Preserving Strategy in Severely Underweight Lung Transplantation: A Prospective, Multicenter, Single-Arm Clinical Study","\\[1\\] Inclusion Criteria\n\n1. Age and informed consent: Age ≥18 years; able to understand the study and provide written informed consent; willing and able to comply with follow-up.\n2. Transplant candidacy: Listed in CLuTR or the participating center's lung transplant waiting list and scheduled to undergo allogeneic lung transplantation.\n3. Low body weight definition (core cohort criterion): Preoperative BMI \\\u003C16 kg\u002Fm², calculated using the most recent traceable preoperative height and weight within the evaluation window.\n4. Preoperative support status: Not receiving ongoing invasive mechanical ventilation (endotracheal intubation or tracheostomy) and not on ECMO or other extracorporeal life support preoperatively.\n5. Minimum acceptable end-organ function: LVEF ≥40%; eGFR ≥40 mL\u002Fmin\u002F1.73 m²; no evidence of acute liver failure or decompensated cirrhosis\u002Fportal hypertension; American Society of Anesthesiologists (ASA) physical status ≤ IV.\n6. Infection and transmissible diseases: No evidence of active infection; no active tuberculosis; HIV\u002FHBV\u002FHCV status meeting center transplant requirements (e.g., undetectable viral load, where applicable).\n7. Rehabilitation and support: Demonstrated potential for postoperative rehabilitation (able to participate in training) and reliable caregiving support (at least one primary caregiver).\n\n\\[2\\] Exclusion Criteria\n\n1. Consent\u002Fcompliance: Refusal or withdrawal of informed consent; investigator judgment that follow-up cannot be completed or presence of recurrent severe non-adherence.\n2. Transplant type: Retransplantation, multi-organ transplantation, or planned lobar lung transplantation.\n3. Recent major cardiovascular\u002Fcerebrovascular events: Acute coronary syndrome\u002Fmyocardial infarction or stroke within the past 30 days.\n4. Severe organ dysfunction\u002Facute failure: LVEF \\\u003C40%; eGFR \\\u003C40 mL\u002Fmin\u002F1.73 m²; acute liver failure or decompensated cirrhosis\u002Fportal hypertension; acute renal failure requiring dialysis with low likelihood of recovery; significant preoperative neuropsychiatric disorder or altered mental status.\n5. High-risk\u002Fsevere infection: Septic shock; active extrapulmonary or disseminated infection; active tuberculosis; detectable HIV viral load (or otherwise not meeting center transplant standards).\n6. High bleeding risk: Severe bronchiectasis not treated with preoperative vascular intervention or not readily correctable.\n7. Malignancy: Active malignancy or malignancy with high risk of recurrence or cancer-related mortality.\n8. Severe chest wall or spinal deformity: Definitively diagnosed severe thoracic cage deformity or spinal deformity.\n9. Substance use\u002Fdependence: Current use of cigarettes, e-cigarettes, inhaled cannabis, or intravenous drugs.\n10. Tubeless\u002Fspontaneous breathing-preserving strategy not safely feasible: Determined by the anesthesia team to have a difficult airway or unsafe supraglottic\u002Fnon-intubated airway management (e.g., anticipated intraoperative airway difficulty, pharyngeal\u002Flaryngeal narrowing not suitable for a laryngeal mask airway), including but not limited to: Mallampati class \\>III, mouth opening \\\u003C3 cm, thyromental distance \\\u003C5 cm, or significant airway anatomic variants (e.g., aberrant right upper lobe bronchial takeoff in a planned right lung transplant) deemed difficult to manage safely with an LMA or single-lumen tube.\n11. Donor\u002Fdonor lung limitations: Donor age \\>60 years; donor mechanical ventilation \\>14 days; positive donor airway microbiology deemed unacceptable by the transplant team.\n12. Protected populations: Pregnant or breastfeeding women.","74 Years",{"count":50,"type":20},56,"INTERVENTIONAL",[53],"NA","The goal of this prospective, multicenter, single-arm clinical study is to learn whether a spontaneous breathing-preserving perioperative management strategy can improve recovery and is safe in lung transplant recipients with very low body weight (body mass index \\[BMI\\] \\\u003C16 kg\u002Fm²).\n\nThe main questions it aims to answer are whether, in lung transplant recipients with very low body weight (BMI \\\u003C16 kg\u002Fm²), a spontaneous breathing-preserving anesthesia-surgical strategy combined with standardized nutritional optimization and a prehabilitation program can improve early postoperative recovery and perioperative survival. Specifically, the study will assess the proportion of participants who require postoperative invasive mechanical ventilation, postoperative length of hospital stay, and perioperative survival within the protocol-defined time window (e.g., through hospital discharge).\n\nParticipants will undergo lung transplantation using a perioperative strategy that preserves spontaneous breathing whenever clinically appropriate, with predefined criteria for conversion to endotracheal intubation and mechanical ventilation if needed. They will receive standard postoperative monitoring and supportive care, with respiratory support events and perioperative complications assessed during the index hospitalization (and up to 30 days after surgery, if specified in the protocol). Key outcomes will be collected from routine clinical care, including postoperative ventilatory support status, length of hospital stay, and major safety events.",[56],"End-stage Lung Disease",[58,59,60],"Lung transplantation","Enhanced Recovery After Surgery","Severely Underweight","NOT_YET_RECRUITING","2026-01-31",{"date":64,"type":32},"2026-02-03",{"date":66,"type":20},"2026-01-13",{"date":68,"type":20},"2029-01-30",{"name":70,"class":71},"The First Affiliated Hospital of Guangzhou Medical University","OTHER",{"id":73,"slug":74,"hasResults":11,"nctId":75,"briefTitle":76,"officialTitle":77,"acronym":4,"eligibilityCriteria":78,"healthyVolunteers":79,"sex":15,"minAge":16,"maxAge":48,"enrollmentInfo":80,"targetDuration":4,"studyType":51,"phases":82,"briefSummary":83,"conditions":84,"keywords":85,"overallStatus":61,"whyStopped":4,"lastUpdateSubmitDate":62,"lastUpdatePostDateStruct":86,"startDateStruct":87,"completionDateStruct":89,"leadSponsor":91,"locationsCount":4},"100622508","perioperative-recovery-outcomes-of-a-spontaneous-breathing-preserving-strategy-in-salvage-lung-transplantation-100622508","NCT07384533","Perioperative Recovery Outcomes of a Spontaneous Breathing-Preserving Strategy in Salvage Lung Transplantation","Perioperative Recovery Outcomes of a Spontaneous Breathing-Preserving Strategy in Salvage Lung Transplantation: A Prospective Multicenter Single-Arm Clinical Study","\\[1\\] Inclusion Criteria\n\n1. Age and informed consent: Age ≥18 years. The participant or their legally authorized representative (LAR) is able to complete the informed consent process in a rescue\u002Femergent transplant setting and sign written informed consent.\n2. Transplant candidacy: Listed in the China Lung Transplantation Registry (CLuTR) or the lung transplant waiting list of the participating center, with a planned allogeneic lung transplantation.\n3. Rescue\u002Fbridge definition (core cohort criterion): Meets any of the following conditions and is deemed by the study team to require rescue\u002Femergent transplantation and to proceed to transplant: continuous invasive mechanical ventilation preoperatively (endotracheal intubation or tracheostomy); or preoperative extracorporeal membrane oxygenation (ECMO) \u002F other extracorporeal life support (ECLS); or urgent escalation of support due to progressive respiratory and\u002For circulatory failure, entering a rescue transplant pathway.\n4. Minimum key organ function: Left ventricular ejection fraction (LVEF) ≥40%; estimated glomerular filtration rate (eGFR) ≥40 mL\u002Fmin\u002F1.73 m²; no evidence of acute liver failure or decompensated cirrhosis\u002Fportal hypertension; American Society of Anesthesiologists (ASA) Physical Status classification ≤ IV.\n5. Infection and transmissible diseases: No evidence of active infection; no active tuberculosis; HIV\u002FHBV\u002FHCV meet the center's transplant requirements (e.g., undetectable viral load, as applicable).\n6. Rehabilitation and support: Demonstrated potential for postoperative rehabilitation (able to cooperate with training) and reliable caregiving support (at least one primary caregiver).\n\n\\[2\\] Exclusion Criteria\n\n1. Informed consent\u002Fadherence: Refusal of or withdrawal of informed consent; investigator judgment that follow-up cannot be completed or that there is repeated serious non-adherence.\n2. Transplant type: Re-transplantation, multi-organ transplantation, or planned lobar lung transplantation.\n3. Recent major cardiovascular\u002Fcerebrovascular events: Acute coronary syndrome\u002Fmyocardial infarction or stroke within the past 30 days.\n4. Severe organ dysfunction\u002Facute failure: LVEF \\\u003C40%; eGFR \\\u003C40 mL\u002Fmin\u002F1.73 m²; acute liver failure or decompensated cirrhosis\u002Fportal hypertension; acute renal failure requiring dialysis with low likelihood of recovery; significant preoperative neuropsychiatric disorder or impaired consciousness.\n5. High risk of severe infection: Septic shock; active extrapulmonary\u002Fdisseminated infection; active tuberculosis; detectable HIV viral load (or otherwise not meeting the center's transplant criteria).\n6. High risk of major bleeding: Severe bronchiectasis not treated with preoperative vascular intervention or not readily correctable.\n7. Malignancy: Active malignancy or malignancy with high risk of recurrence or cancer-related mortality.\n8. Severe chest wall or spinal deformity: Deemed by the study team to compromise surgical exposure, ventilation\u002Fairway management, or perioperative safety.\n9. Substance use\u002Fdependence: Current smoking, e-cigarette\u002Fvaping use, inhaled cannabis use, or intravenous drug use.\n10. Tubeless\u002Fbreathing-preserved strategy not safely feasible: The anesthesia team judges a difficult airway or laryngeal mask\u002Fnon-intubated airway management to be unsafe (e.g., anticipated difficult airway, pharyngeal\u002Flaryngeal stenosis unsuitable for laryngeal mask, or other conditions unfavorable for airway management), including but not limited to: Mallampati class \\>III, mouth opening \\\u003C3 cm, thyromental distance \\\u003C5 cm, or significant airway anatomical variation (e.g., anomalous right upper lobe bronchial origin in a planned right lung transplantation) such that safe management with a laryngeal mask or single-lumen tube is deemed unlikely.\n11. Donor\u002Fdonor lung limitations: Donor age \\>60 years; donor mechanical ventilation \\>14 days; positive donor airway microbiology that the transplant team deems unacceptable.\n12. Protected population: Pregnant or breastfeeding women.",true,{"count":81,"type":20},40,[53],"The goal of this prospective, multicenter, single-arm clinical study is to learn whether a breathing-preserved anesthesia-surgical strategy can improve early recovery and perioperative survival in adults undergoing rescue\u002Fbridge lung transplantation.\n\nThe main questions it aims to answer are whether, in adult rescue lung transplant recipients, a breathing-preserved anesthesia-surgical strategy can improve early postoperative recovery and perioperative survival, with a focus on the need for postoperative invasive mechanical ventilation, postoperative length of hospital stay, and perioperative survival outcomes.\n\nParticipants will undergo lung transplantation using a standardized breathing-preserved anesthesia-surgical pathway, with predefined criteria for conversion to endotracheal intubation and\u002For initiation or escalation of extracorporeal support when clinically necessary. Participants will receive standardized perioperative care per each participating center's transplant pathways and will be followed from screening through hospital discharge and up to 30 days after surgery. Routine perioperative data and key postoperative outcomes, including major complications (e.g., graft dysfunction, respiratory support events, infections, bleeding requiring re-intervention, acute kidney injury, rejection, and thrombotic events), will be collected.",[56],[58,59],{"date":64,"type":32},{"date":88,"type":20},"2026-01-30",{"date":90,"type":20},"2028-03-30",{"name":70,"class":71},{"id":93,"slug":94,"hasResults":11,"nctId":95,"briefTitle":96,"officialTitle":97,"acronym":4,"eligibilityCriteria":98,"healthyVolunteers":11,"sex":15,"minAge":99,"maxAge":4,"enrollmentInfo":100,"targetDuration":4,"studyType":51,"phases":102,"briefSummary":103,"conditions":104,"keywords":105,"overallStatus":61,"whyStopped":4,"lastUpdateSubmitDate":62,"lastUpdatePostDateStruct":106,"startDateStruct":107,"completionDateStruct":108,"leadSponsor":109,"locationsCount":4},"100622506","perioperative-recovery-outcomes-with-a-spontaneous-breathing-strategy-in-older-lung-transplant-recipients-100622506","NCT07384507","Perioperative Recovery Outcomes With a Spontaneous Breathing Strategy in Older Lung Transplant Recipients","Evaluation of Perioperative Recovery With a Spontaneous Breathing-Preserving Strategy in Older Lung Transplant Recipients: A Prospective Multicenter Single-Arm Cohort Study","\\[1\\] Inclusion Criteria\n\n1. Age and informed consent: Age ≥70 years; able to understand the study and provide written informed consent, or, where permitted by ethics and applicable regulations, consent may be provided by a legally authorized representative (LAR)\u002Fauthorized surrogate; willing and able to complete follow-up.\n2. Transplant candidacy: Listed in CLuTR or the lung transplant waiting list of the participating center, with a plan to undergo allogeneic lung transplantation.\n3. Preoperative support status: Not receiving ongoing invasive mechanical ventilation (endotracheal intubation or tracheostomy) preoperatively, and not receiving ECMO or other extracorporeal life support.\n4. Minimum key organ function: LVEF ≥40%; eGFR ≥40 mL\u002Fmin\u002F1.73 m²; no evidence of acute liver failure or decompensated cirrhosis\u002Fportal hypertension; ASA physical status ≤ IV (American Society of Anesthesiologists classification).\n5. Infection and communicable diseases: No evidence of active infection; no active tuberculosis; HIV\u002FHBV\u002FHCV status meets the center's transplant requirements (e.g., undetectable viral load, as applicable).\n6. Rehabilitation and support: Demonstrated potential for postoperative rehabilitation (able to participate in training) and reliable caregiving support (at least one primary caregiver).\n\n\\[2\\] Exclusion Criteria\n\n1. Informed consent\u002Fadherence: Refusal or withdrawal of informed consent; investigator judgment that follow-up cannot be completed or there is recurrent severe non-adherence.\n2. Transplant type: Re-transplantation, multi-organ transplantation, or planned lobar lung transplantation.\n3. Recent major cardio-cerebrovascular events: Acute coronary syndrome\u002Fmyocardial infarction or stroke within the past 30 days.\n4. Severe organ dysfunction\u002Facute failure: LVEF \\\u003C40%; eGFR \\\u003C40 mL\u002Fmin\u002F1.73 m²; acute liver failure or decompensated cirrhosis\u002Fportal hypertension; acute renal failure requiring dialysis with low likelihood of recovery; significant preoperative neuropsychiatric disorders or altered consciousness.\n5. High risk of severe infection: Septic shock; active extrapulmonary\u002Fdisseminated infection; active tuberculosis; detectable HIV viral load (or otherwise not meeting the center's transplant criteria).\n6. High bleeding risk: Severe bronchiectasis without preoperative vascular intervention or not correctable\u002Fmitigable.\n7. Malignancy: Active malignancy or tumors with high risk of recurrence or high cancer-related mortality risk.\n8. Extreme body habitus\u002Fmajor deformity: BMI ≥35 kg\u002Fm² or BMI \\\u003C16 kg\u002Fm²; clearly diagnosed severe chest wall deformity or spinal deformity.\n9. Substance use\u002Fdependence: Current use of cigarettes, e-cigarettes, smoked\u002Fvaped cannabis, or intravenous drug use.\n10. Tubeless\u002Fspontaneous-breathing strategy not safely feasible: Deemed by the anesthesia team to have a difficult airway or unsafe supraglottic\u002Fnon-intubated airway management (e.g., anticipated intraoperative airway difficulty, pharyngeal\u002Flaryngeal stenosis not suitable for a laryngeal mask), including but not limited to: Mallampati class \\>III, mouth opening \\\u003C3 cm, thyromental distance \\\u003C5 cm, or significant airway anatomical variations (e.g., aberrant right upper lobe bronchial takeoff with planned right lung transplantation) where safe management with LMA\u002Fsingle-lumen approaches is judged unlikely.\n11. Donor\u002Fdonor lung limitations: Donor age \\>60 years; donor mechanical ventilation \\>14 days; positive donor airway microbiology considered unacceptable by the transplant team.\n12. Protected populations: Pregnant or breastfeeding women.","70 Years",{"count":101,"type":20},60,[53],"The goal of this prospective, multicenter, single-arm cohort study is to learn whether a lung transplantation approach that preserves patients' spontaneous breathing during surgery can improve early recovery in adults aged 70 years and older undergoing allogeneic lung transplantation.\n\nThe main questions it aims to answer are whether, in adult lung transplant recipients aged 70 years and older, an anesthesia-surgical strategy designed to preserve spontaneous breathing is associated with better early postoperative recovery, specifically in terms of the need for postoperative invasive mechanical ventilation, postoperative length of hospital stay, and perioperative survival.\n\nParticipants will undergo lung transplantation using a standardized anesthesia-surgical strategy intended to preserve spontaneous breathing, with predefined criteria for conversion to tracheal intubation and\u002For ECMO if clinically needed. They will receive standardized perioperative management and routine postoperative care (including ICU monitoring, rehabilitation, and recovery support) as determined by the transplant team. Participants will be assessed throughout hospitalization and followed for postoperative complications and outcomes through discharge and up to 30 days after surgery.",[56],[58,59],{"date":64,"type":32},{"date":88,"type":20},{"date":68,"type":20},{"name":70,"class":71},{"id":111,"slug":112,"hasResults":11,"nctId":113,"briefTitle":114,"officialTitle":115,"acronym":116,"eligibilityCriteria":117,"healthyVolunteers":11,"sex":15,"minAge":16,"maxAge":48,"enrollmentInfo":118,"targetDuration":4,"studyType":51,"phases":120,"briefSummary":121,"conditions":122,"keywords":123,"overallStatus":61,"whyStopped":4,"lastUpdateSubmitDate":62,"lastUpdatePostDateStruct":124,"startDateStruct":125,"completionDateStruct":127,"leadSponsor":129,"locationsCount":4},"100622509","breathe-study-spontaneous-breathing-preserved-anesthesia-and-surgical-strategy-for-hospital-recovery-in-lung-transplantation-100622509","NCT07384546","BREATHE Study: Spontaneous Breathing-Preserved Anesthesia and Surgical Strategy for Hospital Recovery in Lung Transplantation","Spontaneous Breathing-Preserved Anesthesia and Surgical Strategy to Improve Early Postoperative Hospital Recovery After Lung Transplantation (BREATHE), A Prospective, Multicenter, Blinded Endpoint Assessment Single-arm Clinical Study","BREATHE-LTx","【1】Inclusion Criteria\n\n1. Age and informed consent: Aged 18-70 years; able to understand the study and provide written informed consent; willing and able to complete follow-up.\n2. Transplant candidacy: Listed in the CLuTR registry and\u002For the local center's lung transplant waiting list, and scheduled to undergo allogeneic lung transplantation.\n3. Preoperative support status: Not on ongoing invasive mechanical ventilation preoperatively (endotracheal intubation or tracheostomy), and not receiving ECMO or other extracorporeal life support.\n4. Minimum key organ function requirements: LVEF ≥40%; eGFR ≥40 mL\u002Fmin\u002F1.73 m²; no acute liver failure and no evidence of decompensated cirrhosis\u002Fportal hypertension; ASA Physical Status (American Society of Anesthesiologists classification) ≤ IV.\n5. Infection and transmissible diseases: No evidence of active infection; no active tuberculosis; HIV\u002FHBV\u002FHCV status meeting the center's transplant requirements (e.g., undetectable viral load, noticeability per center policy).\n6. Rehabilitation potential and support: Demonstrates postoperative rehabilitation potential (able to cooperate with training) and has reliable caregiving support (at least one primary caregiver).\n\n【2】Exclusion Criteria\n\n1. Informed consent\u002Fadherence: Refusal of or withdrawal of informed consent; investigator judgment that the participant cannot complete follow-up or has recurrent severe non-adherence.\n2. Transplant type: Re-transplantation, multi-organ transplantation, or planned lobar lung transplantation.\n3. Recent major cardiovascular\u002Fcerebrovascular events: Acute coronary syndrome\u002Fmyocardial infarction or stroke within the past 30 days.\n4. Severe organ dysfunction\u002Facute failure: LVEF \\\u003C40%; eGFR \\\u003C40 mL\u002Fmin\u002F1.73 m²; acute liver failure or decompensated cirrhosis\u002Fportal hypertension; acute kidney failure requiring dialysis with low likelihood of recovery; significant preoperative neuropsychiatric disorders or altered consciousness.\n5. High risk of severe infection: Septic shock; active extrapulmonary or disseminated infection; active tuberculosis; detectable HIV viral load (or otherwise not meeting the center's transplant criteria).\n6. High bleeding risk: Severe bronchiectasis in which preoperative vascular intervention has not been performed or bleeding risk cannot be adequately mitigated.\n7. Malignancy: Active malignancy or malignancy associated with a high risk of recurrence or cancer-related mortality.\n8. Extreme body habitus: BMI ≥35 kg\u002Fm² or BMI \\\u003C16 kg\u002Fm²; or a confirmed diagnosis of severe chest wall deformity or spinal deformity.\n9. Substance use\u002Fdependence: Current use of cigarettes, e-cigarettes\u002Fvaping, smoked cannabis, or intravenous drug use.\n10. Tubeless\u002Fspontaneous-breathing strategy not safely feasible: The anesthesia team determines that a difficult airway is anticipated or that laryngeal mask airway (LMA)\u002Fnon-intubated airway management is unsafe (e.g., expected intraoperative airway difficulty, pharyngeal\u002Flaryngeal stenosis unsuitable for LMA), including but not limited to: Mallampati class \\>III, mouth opening \\\u003C3 cm, thyromental distance \\\u003C5 cm, or significant airway anatomical variation (e.g., anomalous right upper lobe bronchial takeoff in candidates for right lung transplantation) deemed difficult to manage safely with an LMA or single-lumen airway.\n11. Donor\u002Fdonor-lung limitations: Donor age \\>60 years; donor mechanical ventilation \\>14 days; positive donor-lung airway culture deemed unacceptable by the transplant team.\n12. Protected populations: Pregnant or breastfeeding women.",{"count":119,"type":20},110,[53],"The goal of this study is to learn whether a spontaneous-breathing (\"tubeless\") anesthesia and surgery strategy can improve early recovery and remain safe for adults who receive a lung transplant. This strategy aims to help lung transplant recipients maintain spontaneous breathing as much as possible during and after surgery, avoid tracheal intubation with invasive mechanical ventilation and deep sedation, and thereby support faster recovery while maintaining postoperative survival and safety. All participants will receive lung transplantation supported by the same spontaneous-breathing (\"tubeless\") strategy. Researchers plan to enroll about 110 participants at several hospitals in China. A separate study team will review the main outcomes using predefined study rules.\n\nThe main questions this study aims to answer are: The main questions this study aims to answer are: among adult lung transplant recipients, does an anesthesia-surgical strategy that preserves spontaneous breathing improve early postoperative recovery while remaining safe during the first 30 days after surgery? The study will focus on the need for postoperative invasive mechanical ventilation, length of postoperative hospital stays, and in-hospital mortality.\n\nParticipants will: Complete screening tests and assessments before surgery (up to about 30 days before the transplant). Undergo lung transplantation using a standardized approach that aims to keep spontaneous breathing function, often using a laryngeal mask airway instead of a breathing tube. Receive pain and cough control measures (such as local anesthesia or nerve block anesthesia) and close monitoring during and after surgery. Receive standard postoperative care. If safety concerns arise, the clinical team will use invasive mechanical ventilation or extracorporeal membrane oxygenation when needed. Be followed during the hospital stay and for 90 days after surgery to record recovery, complications, and readmissions.",[56],[58,59],{"date":64,"type":32},{"date":126,"type":20},"2026-01-10",{"date":128,"type":20},"2027-01-30",{"name":70,"class":71}]