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Lung Transplantation pp 17–40Cite as

Single- and Bilateral Lung Transplantation: Indications, Contraindications, Evaluation, and Requirements for Patients to Be Considered Eligible

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Abstract

Single- and double-lung transplantation epitomize the final therapeutic options available to selected patients with advanced, end-stage lung disease refractory to all methods of available medical management. The lack of evidence supporting effective lung transplant practices is widely acknowledged, necessitating the need for expert opinion practice guidelines. In this chapter we present the key recommendations for consideration when referring and listing an individual for lung transplantation. We critique seminal papers that have revised our selection process for single- and bilateral lung transplant recipients and outline the indications and contraindications unique to different lung pathologies. We define our current clinical practice based on the best available international expert opinions and review future developments of treatments and novel approaches to deal with the continued lack of suitable donor organs.

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Abbreviations

BLT:

Bilateral lung transplant

BMI:

Body mass index

CF:

Cystic fibrosis

CHDAPAH:

Congenital heart disease-associated pulmonary arterial hypertension

COPD:

Chronic obstructive pulmonary disease

CPB:

Cardiopulmonary bypass

CT:

Computed tomography

CTEPH:

Chronic thromboembolic pulmonary hypertension

DLCO:

Diffusing capacity for carbon monoxide

ECLS:

Extracorporeal lung support

ECMO:

Extracorporeal membrane oxygenation

FEV1:

Forced expiratory volume in one second

FVC:

Forced vital capacity

HLT:

Heart-lung transplant

ILD:

Interstitial lung disease

IPAH:

Idiopathic pulmonary arterial hypertension

IPF:

Idiopathic pulmonary fibrosis

ISHLT:

International Society for Heart and Lung Transplantation

LAD:

Lung assist device

LAS:

Lung allocation score

LLLT:

Living lobar lung transplantation

NSIP:

Non-specific interstitial pneumonitis

NTM:

Non-tuberculous mycobacteria

NYHA FC:

New York Heart Association Functional Class

PAH:

Pulmonary arterial hypertension

PH:

Pulmonary hypertension

SLT:

Single-lung transplant

SSc:

Systemic sclerosis

UIP:

Usual interstitial pneumonitis

UNOS:

United Network for Organ Sharing

US:

United States

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Authors and Affiliations

  1. Department of Respiratory Medicine, Freeman Hospital, Newcastle Upon Tyne, UK

    Gerard J. Meachery

  2. Department of Respiratory Medicine, Freeman Hospital and Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK

    Paul A. Corris

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  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of Washington, Seattle, Washington, USA

    Ganesh Raghu

  2. Department of Internal Medicine, University of Genoa, Genoa, Italy

    Roberto G. Carbone

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Meachery, G.J., Corris, P.A. (2018). Single- and Bilateral Lung Transplantation: Indications, Contraindications, Evaluation, and Requirements for Patients to Be Considered Eligible. In: Raghu, G., Carbone, R. (eds) Lung Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-91184-7_2

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