Indication, patient selection and timing of referral for lung transplantation

Bos, S; Pradere, P; Fisher, AJ

doi:10.1183/2312508X.10000824

Indication, patient selection and timing of referral for lung transplantation

Lookup NU author(s): Dr Saskia Bos, Professor Andrew Fisher ORCiD

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Abstract

© ERS 2024.LTx is now an established treatment option for selected patients with end-stage lung diseases, such as COPD, ILD, CF and pulmonary vascular disease, who do not or no longer respond to maximal medical or surgical therapy, or for whom no effective medical therapy exists. The selection of suitable candidates is an ever-evolving discipline, and fewer absolute contraindications to LTx candidacy exist today. To assist in decisions about patient selection and timing of referral and listing, the ISHLT provides consensus recommendations for referring physicians and LTx centres. Referral should occur early enough to allow the LTx team to fully assess the patient’s candidacy, identify and correct modifiable barriers and mitigate potential risk factors. Nevertheless, there is a paucity of robust scientific data on which to rely, and ultimately the decision as to whether a patient is considered a suitable candidate remains mainly centre dependent.