A patient with cystic fibrosis should be considered for double lung transplantation when certain findings are present.

Indications for referring a patient for lung transplant include one or more of the following:

(1) FEV1 postbronchodilator <= 30% of predicted

(2) resting hypoxia (PO2 < 55-60 mm Hg on room air)

(3) hypercapnia (PaCO2 > 50 mm Hg on room air)

(4) FEV1 > 30% of predicted with worsening clinical course (unintended weight loss, increasing frequency and severity of exacerbations, rapidly deteriorating lung function, massive hemoptysis)

(5) FEV1 > 30% of predicted in a female < 18 years of age



• Females less than 18 years of age tend to have a worse prognosis and so should be considered for early referral.


Indications for heart-lung transplantation: cor pulmonale


Contraindications to transplantation:

(1) colonization with antibiotic resistant Pseudomonas species or Burkholderia cepacia

(2) pulmonary aspergilloma

(3) pulmonary mycobacteria

(4) general contraindication for lung transplantation

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