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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