The following criteria outline who may be considered for lung transplantation -- and who is excluded from consideration.

Patients may be considered for lung or heart/lung transplantation if they present with end-stage lung disease including the following conditions:

• No response to conventional treatment
• Limited life expectancy (less than two years)
  
• Severely impaired lifestyle and exercise tolerance, NYHA Class III - IV symptoms
• Oxygen dependence
• Less than 75 years of age, for single lung transplants
• Less than 70 years of age, for double lung transplants
• Less than 60 years of age, for heart/lung transplants

Patients may not be considered for lung or heart/lung transplantation if they exhibit any of the following:

• Active or recent malignancy within two years of curative treatment without evidence of recurrence (within five years for breast cancer and melanoma)
• Irreversible left-sided heat failure with an ejection fraction of less than 45% (these patients would be excluded from consideration for lung transplantation only)
• High dose steroid therapy (more than 40 mg daily) that cannot be tapered or discontinued
• Untreated or uncontrolled psychiatric disorders such as depression and psychosis
• Extrapulmonary end-stage organ disease (multiple-organ transplant may be considered, when appropriate)
• Known active infection or infection with highly resistant pathogens
• History of noncompliance
• Absence of strong social support system
  

The Director may use his discretion for the following relative exclusion criteria:

• Ventilator dependency
• Recent smoking history or substance abuse (within six months)
• Severe cachexia and malnourishment (<20% of ideal body weight)
• Morbid obesity (more than 20% heavier than ideal body weight)
• Severe extrapulmonary or systemic disorders (i.e. active autoimmune disease, poorly controlled IDDM, coronary artery disease
• History of pleurodesis or pleural effusion