Single/Double Lung Patient Selection Criteria
General Indications
All patients considered for pulmonary transplantation shall be suffering from end-stage pulmonary disease and be:
- less than 65 years of age, patients older than 65 will be reviewed on a case-by-case basis
- free from other major organ failure
- free from major psychosocial problems
- capable of participating in pre- and post-operative rehabilitation programs and follow-up
- expected to have a survival time of less than 18 months without a transplant
Specific Indications
Patients with the following disease processes will be considered for lung transplantation:
- Eisenmenger's physiology, COPD, emphysema, Alpha-1 antitrypsin deficiency
- Primary pulmonary hypertension
- Pulmonary fibrosis (primary or secondary)
- Cystic fibrosis
- Bronchiectasis
- Other--including, but not limited to, sarcoidosis, systemic lupus, pulmonary hemosiderosis, bronchiolitis obliterans, broncho alveolar carcinoma, etc.
- Advanced pediatric lung disease
Contraindications
- Absolute:
- a. Significant systemic or multi-system disease
- b. Active or systemic infection limiting survival
- c. Current cigarette smoking (minimum 6-month period of abstinence and a commitment to continue not smoking post-transplant)
- d. Malignancy in the last two years, with the exception of cutaneous squamous and basal cell tumors. In general, a five year disease-free interal is prudent.
- e. Major psychiatric illness
- Relative:
- a. Previous cardiac or thoracic surgery
- b. Diabetes Mellitus
- c. Peptic ulcer disease
- d. Cachexia (<17 BMI) or obesity (>30 BMI: Patient medical summary shall provide details regarding the patient’s body composition)
- e. Corticosteroid therapy (>20 mg/day)
- f. Psychosocial issues
- g. Chemical dependency, including illegal narcotic usage (i.e. marijuana), not consistent with screening criteria in Substance Dependency Addendum
- h. Non-compliance
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