The Lung Transplant Candidate, Indications, Timing, and Selection Criteria

Hannah Mannem; Meghan Aversa; Thomas Keller; Siddhartha G Kapnadak

doi:10.1016/j.ccm.2022.10.001

The Lung Transplant Candidate, Indications, Timing, and Selection Criteria

Clin Chest Med. 2023 Mar;44(1):15-33. doi: 10.1016/j.ccm.2022.10.001.

Authors

Hannah Mannem¹, Meghan Aversa², Thomas Keller³, Siddhartha G Kapnadak⁴

Affiliations

¹ 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.
² 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.
³ 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.
⁴ 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. Electronic address: skap@uw.edu.

PMID: 36774161
DOI: 10.1016/j.ccm.2022.10.001

Abstract

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.

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

Publication types

Review

MeSH terms

Humans
Lung Diseases* / etiology
Lung Diseases* / surgery
Lung Transplantation* / adverse effects
Patient Selection
Risk Factors