Single/Double Lung Patient Selection Criteria

General Indications

All patients considered for pulmonary transplantation shall be suffering from end-stage pulmonary disease and be:

1. less than 65 years of age
2. free from other major organ failure
3. free from major psychosocial problems
4. capable of participating in pre- and post-operative rehabilitation programs and follow-up
5. 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:

1. Eisenmenger's physiology, COPD, emphysema, Alpha-1 antitrypsin deficiency
2. Primary pulmonary hypertension
3. Pulmonary fibrosis (primary or secondary)
4. Cystic fibrosis
5. Bronchiectasis
6. Other--including, but not limited to, sarcoidosis, systemic lupus, pulmonary hemosiderosis, bronchiolitis obliterans, etc.
7. Advanced pediatric lung disease

Contraindications

1. Absolute:
   • a. Significant systemic or multi-system disease
   • b. Active or systemic infection limiting survival
   • c. Significant hepatic disease
   • d. Significant renal disease
   • e. Current cigarette smoking (minimum 6-month period of abstinence and a commitment to continue not smoking post-transplant)
   • f. History of cancer within five years
   • g. Other major medical illness
   • h. Major psychiatric illness
   • i. Inability to cooperate with pre- and post-transplantation follow-up procedures
   • j. Active invasive fungus infection
   • k. BMI>35
2. 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. Ventilator-dependent
   • h. Pan resistant organisms such as b.cepacia
   • i. Systemic hypertension requiring 2 or more antihypertensive agents
   • j. Uncontrolled esophageal reflux
   • k. Symptomatic osteoporosis
   • l. Inability to participate in an exercise program
   • m. Chemical dependency, including illegal narcotic usage (i.e. marijuana), not consistent with screening criteria in Substance Dependence Addendum
   • n. Non-compliance