A patient with chronic obstructive pulmonary disease (COPD) or emphysema may be a candidate for lung transplant if certain poor prognostic factors are present.


Underlying disease:

(1) COPD

(2) emphysema secondary to alpha-1 antitrypsin deficiency

(3) emphysema secondary to other cause


Criteria for considering a patient for lung transplantation:

(1) functional Class III or IV NYHA

(2) postbronchodilator FEV1 < 25% of predicted (others: postbronchodilator FEV1 < 30% of predicted, FEV1 <= 20% of predicted)

(3) rapid decline in FEV1

(4) resting hypoxia (PaO2 < 55-60 mm Hg)

(5) severe hypercapnia

(6) unintended weight loss

(7) significant secondary pulmonary hypertension (cor pulmonale)

(8) frequent life threatening exacerbations


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