Evolution in lung IRI cell death research: a 20-year global bibliometric study (2005–2024)

Background: Lung ischemia-reperfusion injury (LIRI) is a central pathological mechanism underlying primary graft dysfunction after lung transplantation. Regulated cell death modalities - including apoptosis, ferroptosis, and pyroptosis - are increasingly recognized as key drivers of LIRI. However, research is fragmented, with shifting foci and limited integration of the overall knowledge structure. Methods: We retrieved 2462 English-language articles (2005-2024) from the Web of Science Core Collection and conducted a comprehensive bibliometric analysis using CiteSpace, VOSviewer, and Bibliometrix, examining publication trends, international collaborations, keyword co-occurrence, and co-citation networks. Results: The United States (941 publications) and China (809 publications) accounted for 71.1% of global output. Thematic evolution showed a transition from an early focus on "ischemia-reperfusion injury" and "inflammation" to mechanistic studies of "apoptosis" and "oxidative stress." Since 2020, emerging pathways such as "ferroptosis," "mitophagy," and "exosomes" have become prominent, with "ferroptosis" surging in 2022-2023 as a leading frontier. Co-citation analyses revealed that U.S. and Chinese research ecosystems drive experimental modeling and theoretical innovation, respectively, while cross-regional collaboration remains limited. Conclusions: LIRI research is shifting from classical inflammation-apoptosis paradigms toward a multidimensional, mechanistically nuanced framework. The dual-core structure of China and the United States, coupled with increasing integration of basic and clinical studies, highlights a growing convergence across organ systems. The data-driven knowledge map provided here offers a strategic reference for future translational and therapeutic research.