Selection of candidates for lung transplantation

PURPOSE OF REVIEW: Lung transplantation has become a widely accepted treatment in the management of a broad spectrum of end-stage lung disease. Appropriate candidates should have severe lung disease associated with a limited life expectancy. Patients should be sick enough that survival without a transplant would be far worse than with transplantation, but not too sick to survive the time to obtain donor lungs or the procedure. RECENT FINDINGS: In order to contend with the increasing indications for lung transplantation, international guidelines for candidate selection were developed and recently revised in 2006. These guidelines were published to serve as a guide for physicians in selecting appropriate candidates for lung transplantation. SUMMARY: Lung transplantation is a feasible treatment option for a specific group of patients with advanced severe lung disease. Guidelines for the selection of candidates are based on maximizing survival in order to maximize utilization of scarce donor organs. Lung transplantation should be offered to those with the greatest need and best chance of survival. This goal is achieved through early referral followed by a detailed evaluation in order to select the most appropriate candidates for this life-saving intervention.