The Lung Transplant Candidate, Indications, Timing, and Selection Criteria - 10/02/23

Doi : 10.1016/j.ccm.2022.10.001

Hannah Mannem, MD ^a, Meghan Aversa, MD, MS ^b, Thomas Keller, MD ^c, Siddhartha G. Kapnadak, MD ^c,^⁎
^a Division of Pulmonary and Critical Care Medicine, University of Virginia School of Medicine, PO Box 800546, Clinical Department Wing, 1 Hospital Drive, Charlottesville, VA 22908, USA
^b Division of Respirology, Department of Medicine, University Health Network and University of Toronto, C. David Naylor Building, 6 Queen’s Park Crescent West, Third Floor, Toronto, ON M5S 3H2, Canada
^c Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, 1959 Northeast Pacific Street, Campus Box 356522, Seattle, WA 98195, USA

^∗Corresponding author. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, 1959 Northeast Pacific Street, Campus Box 356122, Seattle, WA 98195.Division of Pulmonary, Critical Care, and Sleep MedicineDepartment of MedicineUniversity of Washington School of Medicine1959 Northeast Pacific Street, Campus Box 356122SeattleWA98195

Résumé

Lung transplantation can be lifesaving for patients with advanced lung disease. Demographics are evolving with recipients now sicker but determining candidacy remains predicated on one’s underlying lung disease prognosis, along with the likelihood of posttransplant success. Determining optimal timing can be challenging, and most programs favor initiating the process early and proactively to allow time for patient education, informed decision-making, and preparation. A comprehensive, multidisciplinary evaluation is used to elucidate disease progrnosis and identify risk factors for poor posttransplant outcomes. Candidacy criteria vary significantly by center, and close communication between referring and transplant providers is necessary to improve access to transplant and outcomes.

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Keywords : Lung transplantation, Advanced lung disease, Candidacy, Prognosis, Idiopathic pulmonary fibrosis, Chronic obstructive lung disease, Cystic fibrosis, Pulmonary hypertension