Severe viral pneumonia caused by highly pathogenic viruses frequently leads to acute respiratory distress syndrome (ARDS) and may progress to irreversible pulmonary fibrosis and chronic respiratory failure. Lung transplantation has become a crucial therapeutic option for such end-stage lung injuries. However, due to the heterogeneous clinical course and lack of standardized assessment, identifying transplant timing and suitable candidates remains challenging. This multidisciplinary consensus, based on both international evidence and clinical experience, outlines key principles and structured recommendations for lung transplant evaluation in these patients. The framework addresses transplant indications, imaging and functional assessment of irreversibility, virologic control criteria, potential survival benefit, and postoperative recovery capacity. The consensus emphasizes initiating evaluation during the “window of opportunity,” when lung damage is irreversible, infection is controlled, and the patient remains clinically stable. Recommendations are graded using the Grading of Recommendations Assessment, Development and Evaluation(GRADE) system to guide evidence-based decision-making and improve clinical implementation and transplant outcomes.