Contraindications for Lung Transplantation

Relative Contraindication

Absolute Contraindication

Exception

chronic extrapulmonary medical condition that is poorly controlled or associated with target-organ damage

severe extrapulmonary organ dysfunction

multi-organ transplantation

steroid dependent with daily prednisone > 20 mg per day, or equivalent

invasive mechanical ventilation

acute critical illness

noninvasive mechanical ventilation

extensive pleural thickening from prior thoracic surgery or infection

active collagen vascular disease

preoperative colonization of the tracheobronchial tree with multidrug resistant organism (in cystic fibrosis)

active extrapulmonary infection, including HIV, HBV and HCV

inability to walk

poor rehabilitation potential

severe malnutrition (< 70% ideal body weight)

severe obesity (> 130% of ideal body weight)

active or recent cigarette smoking (with preceding 6 months)

severe psychiatric illness

history of noncompliance with medical therapy

drug or alcohol dependence

localized, well-differentiated lung cancers that can be totally resected

active or metastatic cancer; recent history of cancer with high probability of recurrence

squamous or basal cell carcinomas of the skin

> 65 years old for single lung; > 60 for double lung transplant; > 55 for heart-lung transplant

unable to move to transplant center for time required

contraindication to immunosuppression