Abstract： Objective To estimate the operative technique, operative indications and the outcome of lung transplantation (LT) for idiopathic pulmonary fibrosis (IPF).Methods Of 76 cases receiving LT in our hospital, there were 32 cases of IPF, include 6 females and 26 males with age ranging from 22 to 74 (mean 57.5±12.3 years old).The high resolution CT showed diffuse honeycomb lung.Sixteen cases were diagnosed histopathologically.All of them were oxygen-dependent.The mean pulmonary artery pressure (mPAP) was ≥30 mm Hg (15 cases), PaO_2≤50 mm Hg (28 cases).The surgical procedures included single LT (28 cases) and double LT (4 cases) which were performed via two sequential anterolateral thoracotomies.Twenty cases of them received the ECMO (18/20) support or CPB support (2/20).Results The surgical procedures were done successfully.17 cases postoperative were successfully removed The ECMO was successfully removed postoperatively in 17 cases, and the rest one was died at the 2nd week after the operation due to MODS.There were 4 deaths in the early period (0-30 days ): one due to active bleeding in transplanted lung, 2 due to graft failure, and 1 due to anastomotic bronchial leak at the 2nd week after the operation, and anastomotic bronchial dehiscence at the 8th day after the reoperation.There were 12 cases of acute rejection within postoperative one year.One of them was died of severe acute rejection (A4).Two cases were died of infection.Three-month, one-year, and 3-year overall survival rate for recipients of lung transplants was 84.3 %, 75 %, and 54.5 % respectively.The overall survival half-life was 51 months.Conclusion LT is effective in improving the survival of selected patients with IPF.It can prolong the life expectancy and improve the living quality.Single lung transplant was a routine way for IPF patient.We should select bilateral lung transplant for younger and infected patients.