LUNG TRANSPLANTATION

3. PREOPERATIVE EVALUATION OF LUNG TRANSPLANTATION CANDIDATES
The goal of preoperative evaluation is the identification of individuals most likely
to benefit in terms of survival and rehabilitation following transplantation. Such
individuals are those with end-stage pulmonary disease for which no efficacious or
clinically proven form of treatment other than lung transplantation exists.
Personnel capable of the accurate assessment of such patients include an
appropriately trained pulmonologist, thoracic surgeon, with the assistance of a
social worker and transplantation coordinator.
The general criteria for the selection of potential lung transplantation candidates
include:
3.1 Criteria for Candidate Selection
3.1.1 Evidence of advanced physical incapacitation due to lung disease.
The patient should be functionally limited.
3.1.2 Life expectancy estimated to be weeks or months. Stated
differently, the patient must have less than a 20% likelihood of
surviving one year.
3.1.3 An exception to conditions (3.1.1) and (3.1.2) above is the patients
with intractable respiratory failure.
3.1.4 Agreement that previous medical therapy has been optimal and that
no surgical procedure other than transplantation offers realistic
expectation of functional improvement and extension of life.
3.1.5 The absence of sepsis, irreversible renal or liver dysfunction or other
disease processes (eg. HIV positivity) that might otherwise cause an
early death or be seriously aggravated by transplantation.
3.1.6 Strong family support to aid the patient emotionally during the preand
post-operative period, and for the rest of his/her life.
3.1.7 Satisfactory intelligence, motivation and compliance to compulsively
follow all medical recommendations including attendance at followup
appointments and changes in exercise and dietary regimes.
3.1.8 A reasonable understanding by the patient of his/her current illness
with a realistic attitude and understanding of what transplantation
can offer as well as the potential complications.
3.1.9 A strong will and desire to live and to return to his/her family and
community as a functioning member.
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