Mapping the research trends and hotspots on lung transplant nursing: insights from bibliometric analysis

Introduction

Lung transplantation has evolved into a life-saving treatment that improves the quality of life of patients with end-stage respiratory failure unresponsive to other medical or surgical interventions (1). The International Society for Heart and Lung Transplantation reports that over 70,000 patients have undergone lung transplantation worldwide (2). However, due to the immunological characteristics of the lungs compared to other solid organs, postoperative complications after lung transplantation, such as rejection, airway issues, and lung infections, are prevalent (3). Consequently, a consistently low long-term survival rate has been observed in lung transplant recipients, and the 5-year survival rate of such patients is only 48–59% (4).

Evidence shows that nursing professionals play a crucial role in the rehabilitation of lung transplant patients. The nursing of lung transplant patients is an important, complex, and systematic task, encompassing detailed preoperative assessments (5), the ready provision of equipment and supplies, and coordination during the surgery, including the management of fluids, body temperature, medications, and blood transfusions. In addition, sustained close monitoring and care are also imperative subsequent to the transplantation, which may cover a period of weeks or even months. The nursing care continuum includes immunosuppressive therapy administration, infection prevention, rehabilitation plan formulation, and the provision of lifestyle recommendations (6). Analyzing the challenges experienced by lung transplant recipients related to postoperative nursing and summarizing their nursing experiences in the intensive care setting could promote postoperative recovery and improve the long-term survival rate of these recipients.

Currently, the landscape of lung transplant care is rapidly evolving worldwide, resulting in a significant upsurge in publications in related domains (7). Scholars worldwide have conducted diverse studies concerning lung transplant nursing, including comprehensive investigations into global lung transplant rates and the post-transplant survival status, intervention studies using theoretical frameworks or mobile technology to promote healthy behavioral shifts post-transplantation, and detailed case reports on lung transplant care (8). Despite these endeavors, a comprehensive understanding of the overarching status and prevailing research trends in lung transplant nursing research remains unclear. How to grasp the overall intellectual structure and identify key evolutionary pathways and future priorities from massive, fragmented information? Traditional narrative reviews are inadequate for objectively and quantitatively revealing the macroscopic patterns and dynamic trends within a large body of literature. Thus, a bibliometric analysis was conducted to explore the current state of lung transplant nursing research, identify focal points, and delineate frontiers in this field of study.

Bibliometric analysis is a multidisciplinary research approach. It serves as a valuable tool for analyzing author development, keyword collaborations, and thematic trajectories in specific fields (9). Due to its efficacy in comprehensively evaluating research landscapes, bibliometric analysis has gained substantial traction in recent years, particularly in the medical domain (10). Using tools such as CiteSpace, this investigation examined annual publication trends, countries, authors, research institutions, keywords, and co-citation networks. Employing a quantitative approach, the study generated visual knowledge maps delineating the landscape of lung transplant care to assess the status quo of and global trends in this field. We present this article in accordance with the BIBLIO reporting checklist (available at https://jtd.amegroups.com/article/view/10.21037/jtd-2025-1641/rc).

Methods

Data sources and search strategies

The data for this study were sourced from the Web of Science Core Collection (WOSCC). The retrieval strategy involved a combination of thematic and free-word searches, and the search terms were obtained from the Medical Subject Headings database via PubMed and related references. The following retrieval strategies were employed for this study: TS(Topic) = (“Lung transplantation*” OR “Grafting* , Lung” OR “Lung Grafting*” OR “Transplantation*, Lung”) AND TS(Topic) = (“Nursing*” OR “Nurse-Led” OR “Nursing Care” OR “Nursing Intervention*” OR “Patient Care”). A research retrieval deadline was set until December of the year 2024.

Inclusion and exclusion criteria

The study included journal articles on the topic of lung transplant nursing. Meetings, newspapers, books, conference abstracts, news reports, etc., were excluded from the study, and the article type was refined to “article”. The language was limited to “English”.

Data collection

Two researchers independently searched for and screened the eligible articles, downloaded the total records from WOSCC, selected “full records and cited references” when exporting the information, and saved each article as a “plain text” document to the specified path. Each document was imported into Excel for the statistical analysis. The article titles, authors’ names, nationalities, and affiliations, year of publication, journal name of publication, field of study, keywords and abstracts were extracted from the eligible articles. The data extraction and screening were carried out independently by two researchers, and a third author was consulted if any differences or disagreements arose. The detailed search string is provided in Figure 1.

Figure 1 Flowchart of the literature screening process.

Statistical analysis

CiteSpace was used to investigate the countries/regions, institutional distribution, author collaboration networks, journal distribution, author co-citation, journals co-citation, and literature co-citation. Additionally, it was used to generate keyword co-occurrence networks and perform cluster analyses to identify citation bursts related to specific keywords, thereby aiding in the forecasting of potential research frontiers. The CiteSpace parameters were as follows: time span from database establishment to 2024. The time slice interval was set to 1 year. The node types selected were keyword, author, and institution for the visualization analysis. All the raw data used in the analysis were obtained from public databases, and thus no ethical approval was required.

Results

Publishing trends

As Figure 2 shows, 133 articles met the inclusion criteria. Notably, the publication rate per year was consistently low. This pattern signifies the relatively slow development in the field. From 2004 to 2008, there was a gradual but marginal increase in publications. However, this growth trajectory subsequently stabilized, reflecting a stagnation in the overall development. Subsequently, there was an upward trend in the publications, peaking at 12 articles in years 2022 and 2023. These trends collectively indicate that scholars maintain a certain interest in lung transplant nursing; however, the limited number of publications underscores an inadequacy in this field. In the future, we should strengthen the promotion of the effectiveness of lung transplant nursing in improving the quality of life after lung transplantation, galvanize scholarly enthusiasm for research in the field of lung transplant nursing, and promote its development.

Figure 2 One-year publication output over the study period.

Distribution of countries and institutions

As Figure 3A,3B show, 133 publications were attributed to 26 countries and 278 institutions. The United States (n=67) emerged as the most prolific country in terms of publications, followed by China (n=16). Table 1 presents the top 10 most prolific countries and institutions, displaying their respective publication outputs. Among these institutions, the top 10 collectively contributed 74 (55.64%) articles. Notably, the Pennsylvania Commonwealth System of Higher Education (PCSHE) stands as a prominent node, ranking first with 17 (12.78%) articles, emphasizing its centrality in this research domain. Following the PCSHE, the University of Pittsburgh also featured prominently (9.77%). Figure 3A,3B show the cooperative networks for countries or regions, respectively. The lines between the nodes indicate the cooperative relationship between the countries, and the thickness of the lines reflects the closeness of the cooperative relationship between the countries. In terms of the global cooperation network, we note that the United States collaborated with other countries the most frequently. In Figure 3A,3B, the lines between the nodes indicate that inter-country collaborations exhibited greater visibility than institutional collaborations.

Figure 3 Network diagram showing co-authored publications in terms of countries and institutions. (A) Country collaboration map. (B) Institutional collaboration map.

Journal analysis

The retrieved articles were published in 30 different journals, the top 10 most productive and co-cited of which are listed in Table 2. Six of these publications originated from United States journals. Specifically, the Journal of Heart and Lung Transplantation contributed 10 articles, representing 7.52% of the overall publications, and thus emerged as the journal with the highest publication count, followed by Clinical Transplantation (6.01%). Notably, 5 of the top 10 journals with the most published articles are in the Q1 Journal Citation Reports (JCR) division. The journal of Heart and Lung Transplantation had the highest number of co-cited articles (69 citations), followed by the New England Journal of Medicine (52 citations), Chest (50 citations), and the American Journal of Transplantation (47 citations). Nine of the top 10 co-cited journals were in the Q1 JCR division. The co-cited journals are shown in Figure 4.

Figure 4 Co-occurrence of co-cited journals of CiteSpace.

Author analysis

In total, 343 authors contributed to publications related to lung transplant nursing. Figure 5A provides a collaborative visualization graph of the authors. Each node in the figure represents an individual author, while the connections between the nodes signify collaborative endeavors among authors. An examination of the authors’ network diagram in lung transplant nursing research indicates the presence of numerous independent researchers, alongside several closely collaborating research teams. Notably, the research team led by Dobbels demonstrated notably cohesive collaboration. CiteSpace was used to analyze the co-cited author network graphs with citation frequencies ≥5 (Figure 5B). Dew (26 citations) was cited the most frequently, followed by Forsberg (21 citations).

Figure 5 Network diagrams of co-authored articles. (A) Author collaboration network. (B) Co-cited authors.

Reference analysis

The examination of references, as repositories of knowledge, offers valuable insights into foundational research in a specific field. Reference co-citation refers to instances in which two or more articles are simultaneously cited by one or more articles, enabling the evaluation of correlations between these articles. The graphic depiction in Figure 6 illustrates correlations among references, discernible through the distance between two references or the color of the nodes. Table 3 presents the top 10 most cited references. Notably, Dabbs (Am J Transplant, 2016, 7 citations) had the largest number of citations, followed by De Geest (Transpl Int, 2014, 6 citations).

Figure 6 Network map showing the co-citation analysis of references.

Keyword analysis

Keyword co-occurrence analysis

CiteSpace was used to identify research hotspots and frontiers in the retrieved publications. The node size in the graph represents the frequency of the keyword occurrence, with larger nodes and fonts denoting higher keyword usage frequencies. As Figure 7A shows, 327 keywords were extracted from the pool of 133 documents. The keywords “lung transplantation” and “care” were amalgamated with their synonyms to accurately elucidate research hotspots. For the keyword “lung transplantation”, we merged it with its variants and closely related terms to comprehensively capture the core subject. The group included: “lung transplant”, “lung grafts”, “pulmonary transplantation” and “double-lung transplantation”. For the keyword “care”, we merged it with terms representing the broader concept of patient management and support following surgery. The group included: “patient care”, “management”, “support”, “recovery” and “rehabilitation”. Table 4 presents the top 10 keywords with the highest frequency and centrality. The findings revealed that the pivotal keywords in the domain of lung transplantation included “quality of life” (35 citations), “recipients” (15 citations), “heart” (14 citations), “heart transplantation” (12 citations), “care” (10 citations), “experience” (9 citations), “international society” (9 citations), “disease” (8 citations), “management” (8 citations), and “organ transplantation” (7 citations). Notably, “quality of life” held the highest citation rate, reflecting a paradigm shift in lung transplant nursing. This shift extends beyond the conventional focus on clinical symptoms, indicating a heightened emphasis on enhancing the overall quality of life of patients, which aligns with advancements in medicine and an elevated standard of living.

Figure 7 Keyword analysis: (A) keyword co-occurrence; (B) keyword cluster diagram; (C) timeline view of the keywords; (D) maps of the top 20 keywords in most citations.

Keyword clustering graph analysis

Figure 7B shows the clustering analysis of lung transplant nursing research. The smaller the clustering ordinal, the more nodes and keywords it contains, and the higher the popularity of the clustering research. The higher the profile value, the more important clustering becomes in on-site analysis. From the clustering labels, it can be seen that #0 lung transplantation, #1 waiting list, #2 family, #3 complications, #4 bronchoalveolar lavage, #5 transplant effects questionnaire, #6 heart transplant, #7 heart failure, #8 asthma, #9 pulmonary hygiene, #10 survival, #11 advance care planning, #12 patient-sentroit care, and #13 kidney transplantation were the most discussed topics in this field. Clustering labels can be divided into the following categories: (I) type of organ transplantation: #0 lung transplantation, #6 heart transplant, and #13 kidney transplantation; (II) perioperative care: #11advance care planning, #12 patient-centered care, #2 family, #5 transplant effects questionnaire, #10 survival, and #3 complications; and (III) complication monitoring and prevention: #4 bronchoalveolar lavage, #7 heart failure, #8 asthma, and #9 pulmonary hygiene.

Keyword timeline view and burst analysis

Figure 7C displays a timeline map generated via CiteSpace using a network of keywords from co-occurring authors. A keyword timeline view was generated using the cluster name as the vertical axis and the year of publication as the horizontal axis. The visualization reveals that as early as 1996, numerous scholars had researched lung transplant nursing. This timeline reveals that the academic exploration of this field began in the 1990s or even earlier. Over time, an increasing number of researchers and scholars have contributed to this field, indicating a sustained global interest in lung transplant nursing. The dynamic nature of keyword frequency and mutation over time serves as a determinant for identifying research hotspots in lung transplant nursing. This analysis not only delineates recent research trends but also serves as a potential indicator of future research trends in this field.

The analysis of burst keywords serves as a valuable tool in exploring the evolving research frontiers in lung transplant nursing across different phases. CiteSpace showed that the top 20 keywords with the highest citations (Figure 7D) were “rejection”, “bronchitis”, “infection”, “transbronchial biopsy”, “allograft rejection”, “bronchoalveolar lavage”, “chronic obstructive pulmonary disease”, “asthma”, “communication”, “nursing care”, “organ transplantation”, “lung”, “kidney”, “lung cancer”, “recipient”, “heart”, “mortality”, “anxiety”, “mental health”, and “nonadherence”. Further examination of the top 20 keywords exhibiting the most robust citation bursts suggested a division in the entire timeframe into two distinct periods: Period I (1997–2011), and Period II (2016–2024). During Period I, the research emphasis was notably directed toward monitoring and nursing interventions addressing complications after lung transplantation, particularly focusing on rejection-related aspects. Conversely, in Period II, there was a notable shift signaled by keywords such as “mental health” and “nonadherence”, indicating that the psychological changes in lung transplant recipients and patient adherence have attracted increasing attention from researchers in recent years.

Discussion

This study provides the visual analysis of nursing researches on lung transplantation from 1996 to 2024. Most existing reviews in the transplant field are qualitative summaries, while this study presents the core author network, highly cited literature, and evolution of hot keywords in this subfield through visual data, providing an objective basis for scholars in the field to quickly locate the research core. Secondly, the research provided a baseline analysis. When the volume of literature in this area grows in the future, our study can serve as a benchmark for assessing the rate of development and evolving trends.

Analysis of basic information

This study used CiteSpace to analyze articles on lung transplant nursing studies published from the establishment of the database to year 2024. This analysis included publication volumes, countries/regions, institutions, keyword co-occurrences, clustering and emergence, and journal co-citations. The findings indicate the relatively slow of research on lung transplant nursing in foreign countries. Several factors might have contributed to this trend. First, the historical development of lung transplantation research is relatively brief. While lung transplantation surgeries have been ongoing for approximately half a century, the research on lung transplant nursing spans less than 30 years. This duration is notably shorter compared to the research history of heart and kidney transplant nursing by almost 20 years (11). Second, the limited availability of suitable organs for transplantation, coupled with the inherent complexity of the surgical procedure, contributes to a limited number of lung transplantation surgeries overall. This scarcity poses challenges in data collection and limits the generalizability of conclusions drawn from the limited data (12). However, amid the continuous advancements in lung transplantation surgical techniques and their integration with emerging technologies, a notable shift has emerged. During the novel coronavirus pneumonia epidemic, the reported instances of lung transplants surpassed 70,000 worldwide (13). This development signals a new phase in global lung transplantation, potentially influencing the trajectory of research in lung transplant nursing. The potential surge or alteration in the trend of lung transplant nursing research warrants further exploration in the future.

Further, due to the distinct characteristics of lungs and the challenges posed by poor preoperative lung function, significant surgical stress, and long-term postoperative immunosuppression, and hormone therapy, lung transplant recipients are highly susceptible to rejection reactions, infections, metabolic disorders, and other complications. The average survival period of these patients is only 6.8 years, and their prognosis is poor compared to those who receive other solid organ transplants (14). Research indicates that an important factor affecting the postoperative survival rate is perioperative treatment and nursing (15). Therefore, research on lung transplant nursing needs to be fostered to enhance survival rates after lung transplantation and improve the overall quality of life of patients.

Analyzing the top 10 countries/regions and institutions in terms of publication volume, the United States emerged as the most prolific country, exhibiting a centrality of 0.15. The top two institutions (i.e., the PCSHE and University of Pittsburgh) with the highest number of publications were both from the United States. This underscores the dominance of the United States in lung transplant care research, which can be attributed to its developed economy and formidable scientific research foundation(16). However, there remains a dearth of extensive collaboration and information sharing among different countries, with country-specific studies predominating. Therefore, cooperation and exchange between research institutions and researchers from different countries should be strengthened to facilitate the dissemination of information, innovate research methodologies, and surmount existing research hurdles.

Lundmark and Forsberg et al. have multiple studies and high citation rates in lung transplant care. Their work focuses on enhancing postoperative patient self-management and prioritizing mental health and overall well-being (17,18). Forsberg et al. conducted a national survey to assess postoperative pain, fatigue, and happiness, and the results of the survey formed the basis for a follow-up intervention to improve patient quality of life. In addition, Dew et al. (19) have been cited extensively despite fewer publications. This suggests that there is not necessarily a link between the number of published papers and their quality.

The impact factors of the journals were generally low (Table 2). Indeed, less than half of the top 10 Journals belong to the JCR Q1 category, indicating a need for more impactful research. The Journal of Heart and Lung Transplantation had the highest number of publications among the top 10 journals. The impact factor values of these top 10 journals ranged from 0.8 (Transplantation Proceedings) to 9.5 (Chest), with the values of most journals ranging from 1 to 4, indicating authors’ preferences for appropriate journals. Nine of the top 10 cited journals in lung transplant care were American, highlighting the United States’ prominent role in this field. The Journal of Heart Lung Transplantation ranked first among the co-cited journals with 64 citations. However, we emphasize that a high citation count may arise for various reasons, including a study’s importance, controversy, or even its use as a methodological reference, and therefore it does not directly equate to high quality or high clinical relevance.

In addition, upon our analysis, the field of lung transplant nursing care is characterized by a predominance of lower-level evidence. The majority of the 133 identified studies are observational studies (e.g., cohort studies, case-control studies) and case series/s reports. Randomized controlled trials (RCTs) are scarce. This is primarily due to the significant ethical and practical challenges in conducting RCTs in this vulnerable patient population, such as the difficulties in blinding interventions and establishing standard-of-care control groups as well as sample size limitations. Future lung transplant care research should shift focus towards adopting innovative study designs and enhancing multicenter data collaboration to generate higher-level evidence within an ethical framework.

Analysis of research trends

Analysis of hotspots

Keyword co-occurrence maps, clustering maps, and time zone maps can effectively indicate the hotspots and changes in lung transplant nursing research. Examining the evolution of this field alongside our study’s findings revealed the following key research areas: investigating diverse organ transplantation types (e.g., heart transplantation, kidney transplantation, and lung transplantation); refining perioperative care specific to lung transplantation; monitoring and preventing postoperative complications; and enhancing overall quality of life.

Lung transplantation, a life-saving procedure for those with end-stage lung disease, initially paralleled the development of other solid organ transplants. However, lung transplantation will take longer to evolve into a routine treatment than other types of transplantation (20). Existing literature delves into the care of simultaneous multiple organ transplantations, but experts have largely developed lung transplant care by summarizing insights from other organ transplants (21). Ongoing vigilance over transplanted organs is crucial for detecting and preventing post-transplant complications (22). Monitoring graft function remains crucial; however, the ultimate aim extends beyond mere survival to restoring patients to their pre-disease health, necessitating a balance between graft functionality and the psychological and physical well-being of the recipient (23). Therefore, evaluating the quality of life of lung transplant recipients is important, as it reflects the recipients’ daily functions in the family and society (24).

Quality of life has emerged as a new medical indicator in lung transplant medicine. Evaluating quality of life should constitute a fundamental component of post-transplant assessments (25). Globally, the quality of life for lung transplant recipients has drawn significant attention and discourse among scholars, who have focused on factors affecting recipients’ long-term quality of life after transplantation. While previous studies have primarily highlighted improvements in the physical dimension of patients’ quality of life after lung transplantation, the overall quality of life of patients after transplantation comprises diverse aspects (physical, psychological, and social) influenced by personal experiences, beliefs, expectations, and perceptions across various fields (26-29). Despite improvements, the overall quality of life of lung transplant recipients remains inferior to that of the general population (30). Thus, future intervention studies need to be conducted to improve the quality of life of lung transplant recipients.

Analysis of frontiers

The frequency and mutation degree of emerging words serve as indicators of the leading domains and development trends in lung transplant nursing research. By combining the keyword timeline and highlight plots, a clear pattern has emerged in recent years, emphasizing the focus of lung transplant nursing research on addressing treatment methodologies and psychological well-being among lung transplant recipients. In particular, the prevalent emergence and sustained duration of “anxiety” as an emotion over the past three years represents a potential area for future research. In the future, researchers could continue comprehensive and in-depth investigations in this area.

Despite consistent research affirming that treatment adherence among lung transplant recipients can enhance outcomes (31), research on the risk factors associated with non-compliance in this patient population is limited. Research reports that the nonadherence range for medication, healthcare recommendations, lifestyle recommendations, and follow-up care plans among lung transplant recipients ranges from 3.1% to 10.6% (32). Moreover, the perception is that non-compliance is a complex behavior influenced by patient factors, healthcare professionals, and the healthcare system (33). Presently, patient-related factors remain the most extensively studied influencing factor (34). In reality, patients often contend with multiple factors that affect their compliance. A study highlight that forgetting to take medications and doubts about treatment efficacy are frequently cited as reasons affecting patient drug compliance (35). However, some factors fall outside the patients’ control, including service-level considerations such as ensuring comprehensive post-transplant care and policy-level factors (36).

Given the role of high non-compliance rates in the management and treatment outcomes of chronic diseases, scholars worldwide are actively engaged in exploring effective measures to address the challenge of poor patient treatment adherence. These efforts encompass personalized and continuous health education, the optimization of treatment plans, the implementation of medication reminders, cognitive behavioral therapy interventions, and the use of remote nursing technologies (37). However, existing issues, such as the limited number of participants undergoing interventions and the scarcity of high-quality research evidence on intervention measures, have led to reduced credibility regarding the effectiveness of such interventions (38). Compliance management, an often-overlooked aspect of chronic disease management, holds significant importance. Enhanced compliance not only optimizes the use of medical resources but also ensures maximal patient benefit (39). Therefore, improving patient treatment compliance has emerged and will continue as a prominent trend in future research endeavors.

Anxiety has emerged as the predominant symptom among lung transplant recipients, garnering considerable attention and becoming a prevalent trend in recent research in this field. At present, with the continuous maturity of lung transplantation technology and corresponding active nursing interventions, the physical quality of life of patients after lung transplantation and their self-care abilities can be improved (40). Nevertheless, anxiety remains persistently prevalent among patients postoperatively. Studies have reported anxiety disorder incidence rates ranging from 18.4% to 25.3% during the waiting period for transplantation (41), and of 22% in the initial two years after lung transplantation, suggesting a lack of improvement in the psychological well-being of these patients (42). Anxiety are potentially associated with prolonged waitlist status before surgery, concerns related to surgical outcomes, postoperative complications, and long-term immunosuppressive medications (43). The use of new immunosuppressants and the prolongation of survival have exposed patients to various long-term complications and life challenges (e.g., employment, family relationships, changes in body image), all of which can serve as new sources of anxiety (44). However, to date, no consensus has been reached as to whether anxiety solely exerts a negative effect on patients. Storaasli et al. (45) identified persistent and severe anxiety as a primary negative symptom among lung transplant recipients, and found that it was correlated with an increased risk of mortality. Conversely, Wessels-Bakker et al. (46) found a significant positive correlation between anxiety and drug compliance, suggesting that patients with anxiety disorders tend to exhibit higher adherence due to their fear of worsening illness and rejection. Despite these insights, longitudinal studies investigating the relationship and potential mechanisms between anxiety and treatment compliance are lacking, necessitating further exploration in the future.

Limitations

This study used bibliometrics and visual analyses to analyze the current situation and global trends in the field of lung transplant nursing research, which makes the study relatively detailed and objective. However, this study still had some inevitable limitations. First, to improve the reliability of the publications in this study, the research only retrieved articles from the WoSCC database; thus, it lacked comprehensive data. Second, in the process of retrieval, the language of the articles was limited to English, which led to the omission of non-English publications. Nevertheless, the literature-based visual analysis undoubtedly lays a foundation for scholars to quickly understand the research topics, research hotspots, and development trends in the field of lung transplant nursing.

Conclusions

This study conducted a comprehensive bibliometric analysis of international research on lung transplant nursing. Presently, lung transplant nursing is in an exploratory phase, characterized by a limited publication volume and overall slow development. Further, the overall impact of factors addressed in the literature is generally low, with a scarcity of highly impactful articles in the field of lung transplant nursing. Future efforts should emphasize enhanced collaboration among countries and regions, fostering frequent academic exchanges to yield superior research outcomes. Current research priorities focus on perioperative nursing, monitoring and preventing postoperative complications, and enhancing quality of life, while future investigations are likely to focus on mental health (anxiety) and treatment compliance. Our findings may serve as a guide for researchers to comprehend the current status and leading trends in this field, offering a comprehensive outlook on lung transplant care.

Acknowledgments

The authors would like to express their appreciation to Professor CM Chen who invented CiteSpace, which is free to use.

Footnote

Reporting Checklist: The authors have completed the BIBLIO reporting checklist. Available at https://jtd.amegroups.com/article/view/10.21037/jtd-2025-1641/rc

Peer Review File: Available at https://jtd.amegroups.com/article/view/10.21037/jtd-2025-1641/prf

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-2025-1641/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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