Pulmonary Fibrosis

Waiting list for lungs

06/30/2009

Question:

visited my friend. already on oxygen. has pulmonary fibrosis. needs a double lung transplant. but is still not yet on the waiting list for the lungs. he`s lost a lot of weight. he will die soon, I sense it. even if I`m wrong, he`s very sick and not on the list yet. I wonder what the doctors are thinking?

Answer:

To get a lung transplant, a patient must meet a number of requirments and these requirements may vary slightly from one transplant center to another. Some of the common reasons that patients are not listed for transplant include

obesity (most transplant centers will want the body mass index to be less than 30),

any history of smoking within the past 6 months,

age (there is not a firm age limit but generally 65-70 years old is the practical limit),

lack of medical insurance (or other financial resources), and

serious underlying medical problems (such as infections, heart disease, liver disease, kidney disease, or psychiatric disease).

Patients are not placed on a transplant list unless they meet all of these criteria and until they have a "score" that indicates that they are sick enough to be on the list. The patients with the highest score then move to the top of the list. Some patients can be so advanced that they are too sick to be placed on a transplant list - most transplant centers require that a patient be able to do some minimal amount of exercise (commonly measured by a minimum distance walked during a 6-minute walk test); those who are too debilitated generally have a lower chance of surviving the surgery.

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Response by:

James N. Allen, Jr., MD
Professor - Clinical
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University