Who is a candidate for a lung transplantation?

Lyall A. Gorenstein, MD
Thoracic Surgery (Cardiothoracic Vascular)
Candidates for lung transplantation are severely impaired in their daily activities. They are without the possibility of alternative medical or surgical therapy and, left untreated, have a poor outlook for long-term survival. Unfortunately, not all of these individuals will benefit from transplantation. Those who have severe systemic diseases or active infections and those who cannot comply with regular follow-up care after transplant should not undertake the operation.
Not everyone with end-stage pulmonary disease will be eligible for transplantation. The first goal of the program is to determine whether lung transplantation is the best option for each patient. The evaluation process may be performed in patients who meet certain criteria:

- No acute and/or critical illness
- No significant other organ dysfunction, such as severe heart, kidney or liver disease
- No active cancer within last two to five years depending on the type and stage of cancer
- Abstinence from cigarette smoking, heavy alcohol use and drug addiction for at least six months
- Track record of compliance with follow-up visits and medications
- No significant and active psychiatric problems
- Current body weight with a BMI of less than 30
- Ability to pass a standard six-minute walk test and participate in pulmonary rehabilitation program
- No HIV infection, or chronic hepatitis
- No infection with certain difficult-to-treat micro-organisms

The evaluation process includes an initial screening, multiple tests and consultations, and laboratory assessment. Candidates for transplantation are evaluated by members of the transplant team including the transplant pulmonologist, surgeon, transplant coordinator, psychiatrist, social worker, financial counselor, and in some cases, a cardiologist and gastroenterologist.

The complete outpatient testing and consultation process requires three to four full days at the hospital, which may be scheduled during the course of four to six weeks. The test results are then reviewed with the patient and discussed at the multi-disciplinary team meeting to make a decision.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.