The Journal of Heart and Lung Transplantation
Volume 25, Issue 7 , Pages 745-755 , July 2006

International Guidelines for the Selection of Lung Transplant Candidates: 2006 Update—A Consensus Report From the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation

  • Jonathan B. Orens, MD

      Affiliations

    • Johns Hopkins University, Baltimore, Maryland
    • Corresponding Author InformationReprint requests: Jonathan B. Orens, MD, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street (5th floor), Baltimore, MD 21287. Telephone: 410-955-3468. Fax: 410-955-0036.
  • ,
  • Marc Estenne, MD

      Affiliations

    • Erasme University, Brussels, Belgium
  • ,
  • Selim Arcasoy, MD

      Affiliations

    • Columbia University, New York, New York
  • ,
  • John V. Conte, MD

      Affiliations

    • Johns Hopkins University, Baltimore, Maryland
  • ,
  • Paul Corris, MD

      Affiliations

    • Newcastle University, Newcastle-upon-Tyne, UK
  • ,
  • Jim J. Egan, MD

      Affiliations

    • Mater Hospital, Dublin, Ireland
  • ,
  • Thomas Egan, MD

      Affiliations

    • University of North Carolina, Chapel Hill, North Carolina
  • ,
  • Shaf Keshavjee, MD

      Affiliations

    • University of Toronto, Toronto, Ontario, Canada
  • ,
  • Christiane Knoop, MD

      Affiliations

    • Erasme University, Brussels, Belgium
  • ,
  • Robert Kotloff, MD

      Affiliations

    • University of Pennsylvania, Philadelphia, Pennsylvania
  • ,
  • Fernando J. Martinez, MD

      Affiliations

    • University of Michigan, Ann Arbor, Michigan
  • ,
  • Steven Nathan, MD

      Affiliations

    • Inova Fairfax Hospital, Fairfax, Virginia
  • ,
  • Scott Palmer, MD

      Affiliations

    • Duke University, Durham, North Carolina
  • ,
  • Alec Patterson, MD

      Affiliations

    • Washington University, St. Louis, Missouri
  • ,
  • Lianne Singer, MD

      Affiliations

    • University of Toronto, Toronto, Ontario, Canada
  • ,
  • Gregory Snell, MD

      Affiliations

    • Alfred Hospital, Prahan, Australia
  • ,
  • Sean Studer, MD

      Affiliations

    • University of Pittsburgh, Pittsburgh, Pennsylvania
  • ,
  • J.L. Vachiery, MD

      Affiliations

    • Erasme University, Brussels, Belgium
  • ,
  • Allan R. Glanville, MD

      Affiliations

    • St. Vincent’s Hospital, Sydney, Australia

Received 12 January 2006 ,Revised 12 January 2006 ,Accepted 13 March 2006.

References 

  1. Maurer JR , Frost AE , Estenne M , Higenbottam T , Glanville AR . International guidelines for the selection of lung transplant candidates. The International Society for Heart and Lung Transplantation, the American Thoracic Society, the American Society of Transplant Physicians, the European Respiratory Society . J Heart Lung Transplant . 1998;17:703–709
  2. Trulock EP , Edwards LB , Taylor DO , Boucek MM , Keck BM , Hertz MI . Registry of the International Society for Heart and Lung Transplantation (twenty-second official adult lung and heart-lung transplant report—2005) . J Heart Lung Transplant . 2005;24:956–967
  3. Boucek MM , Edwards LB , Keck BM , Trulock EP , Taylor DO , Hertz MI . Registry of the International Society for Heart and Lung Transplantation (eighth official pediatric report—2005) . J Heart Lung Transplant . 2005;24:968–982
  4. Charman SC , Sharples LD , McNeil KD , Wallwork J . Assessment of survival benefit after lung transplantation by patient diagnosis . J Heart Lung Transplant . 2002;21:226–232
  5. Demeester J , Smits J , Persijn GG , Haverich A . Listing for lung transplantation (Life expectancy and transplant effect, stratified by type of end-stage lung disease, the Eurotransplant Experience) . J Heart Lung Transplant . 2001;20:518–524
  6. Thabut G , Mal H , Castier Y , et al.   Survival benefit of lung transplantation for patients with idiopathic pulmonary fibrosis . J Thorac Cardiovasc Surg . 2003;126:469–475
  7. Geertsma A , ten Vergert EM , Bonsel GJ , de Boer WJ , van der BW . Does lung transplantation prolong life? A comparison of survival with and without transplantation . J Heart Lung Transplant . 1998;17:511–516
  8. Hosenpud JD , Bennett LE , Keck BM , Edwards E , Novick RJ . Effect of diagnosis on survival benefit of lung transplantation for end-stage lung disease . Lancet . 1998;351:24–27
  9. Gerbase MW , Spiliopoulos A , Rochat T , Archinard M , Nicod LP . Health-related quality of life following single or bilateral lung transplantation (a 7-year comparison to functional outcome) . Chest . 2005;128:1371–1378
  10. Gross C , Savik K , Bolman M , Hertz MI . Long-term health status and quality-of-life outcomes of lung transplant recipients . Chest . 1995;108:1587–1593
  11. Maish AB . Priorities for lung transplantation among patients with cystic fibrosis . JAMA . 2002;287:1524–1525
  12. Kanasky WF , Anton SD , Rodrigue JR , Perri MG , Szwed T , Baz MA . Impact of body weight on long-term survival after lung transplantation . Chest . 2002;121:401–406
  13. Parekh K , Meyers BF , Patterson GA , et al.   Outcome of lung transplantation for patients requiring concomitant cardiac surgery . J Thorac Cardiovasc Surg . 2005;130:859–863
  14. Connors A , Dawson N , Thomas C , et al.   Outcomes following acute exacerbation of severe chronic obstructive lung disease . Am J Respir Crit Care Med . 1996;154:959–967
  15. Oga T , Nishimura K , Tsukino M , Sato S , Hajiro T . Analysis of the factors related to mortality in chronic obstructive pulmonary disease (role of exercise capacity and health status) . Am J Respir Crit Care Med . 2003;167:544–549
  16. Celli BR , Cote CG , Marin JM , et al.   The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease . N Engl J Med . 2004;350:1005–1012
  17. Fishman A , Martinez F , Naunheim K , et al.   A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema . N Engl J Med . 2003;348:2059–2073
  18. Egan TM , Bennett LE , Garrity ER , et al.   Predictors of death on the UNOS lung transplant waiting list (results of a multivariate analysis) . J Heart Lung Transplant . 2001;20:242
  19. US Department of Health and Human Services HRaSA United Network for Organ Sharing The Scientific Registry of Transplant Recipients . 2003 annual report of the US Organ Procurement and Transplantation Network . 2006; Available at http://www.ustransplant.org/annual_reports/archives/2003/default.htm. Accessed April 11, 2006.
  20. Egan TM , Detterbeck FC , Mill MR , et al.   Long-term results of lung transplantation for cystic fibrosis . Eur J Cardiothorac Surg . 2002;22:602–609
  21. Liou TG , Adler FR , Cahill BC , et al.   Survival effect of lung transplantation among patients with cystic fibrosis . JAMA . 2001;286:2683–2689
  22. De Soyza A , Archer L , Wardle J , et al.   Pulmonary transplantation for cystic fibrosis (pre-transplant recipient characteristics in patients dying of peri-operative sepsis) . J Heart Lung Transplant . 2003;22:764–769
  23. Aris RM , Gilligan PH , Neuringer IP , Gott KK , Rea J , Yankaskas JR . The effects of panresistant bacteria in cystic fibrosis patients on lung transplant outcome . Am J Respir Crit Care Med . 1997;155:1699–1704
  24. Dobbin C , Maley M , Harkness J , et al.   The impact of pan-resistant bacterial pathogens on survival after lung transplantation in cystic fibrosis (results from a single large referral centre) . J Hosp Infect . 2004;56:277–282
  25. Chaparro C , Maurer J , Gutierrez C , et al.   Infection with Burkholderia cepacia in cystic fibrosis (outcome following lung transplantation) . Am J Respir Crit Care Med . 2001;163:43–48
  26. Aris RM , Routh JC , LiPuma JJ , Heath DG , Gilligan PH . Lung transplantation for cystic fibrosis patients with Burkholderia cepacia complex. Survival linked to genomovar type . Am J Respir Crit Care Med . 2001;164:2102–2106
  27. Liou TG , Adler FR , Huang D . Use of lung transplantation survival models to refine patient selection in cystic fibrosis . Am J Respir Crit Care Med . 2005;171:1053–1059
  28. De Soyza A , McDowell A , Archer L , et al.   Burkholderia cepacia complex genomovars and pulmonary transplantation outcomes in patients with cystic fibrosis . Lancet . 2001;358:1780–1781
  29. Levine SM . A survey of clinical practice of lung transplantation in North America . Chest . 2004;125:1224–1238
  30. McMenamin JD , Zaccone TM , Coenye T , Vandamme P , LiPuma JJ . Misidentification of Burkholderia cepacia in US cystic fibrosis treatment centers (an analysis of 1,051 recent sputum isolates) . Chest . 2000;117:1661–1665
  31. Klima LD , Kowdley KV , Lewis SL , Wood DE , Aitken ML . Successful lung transplantation in spite of cystic fibrosis-associated liver disease (a case series) . J Heart Lung Transplant . 1997;16:934–938
  32. Flume PA , Egan TM , Westerman JH , et al.   Lung transplantation for mechanically ventilated patients . J Heart Lung Transplant . 1994;13:15–21
  33. Bartz RR , Love RB , Leverson GE , Will LR , Welter DL , Meyer KC . Pre-transplant mechanical ventilation and outcome in patients with cystic fibrosis . J Heart Lung Transplant . 2003;22:433–438
  34. Egan T , McCullough K , Murray S , et al.   Risk factors for death after lung transplant in the U.S . J Heart Lung Transplant . 2003;22:S146–S147
  35. Kerem E , Reisman J , Corey M , Canny GJ , Levison H . Prediction of mortality in patients with cystic fibrosis . N Engl J Med . 1992;326:1187–1191
  36. Liou TG , Adler FR , FitzSimmons SC , Cahill BC , Hibbs JR , Marshall BC . Predictive 5-year survivorship model of cystic fibrosis . Am J Epidemiol . 2001;153:345–352
  37. Augarten A , Akons H , Aviram M , et al.   Prediction of mortality and timing of referral for lung transplantation in cystic fibrosis patients . Pediatr Transplant . 2001;5:339–342
  38. Mayer-Hamblett N , Rosenfeld M , Emerson J , Goss CH , Aitken ML . Developing cystic fibrosis lung transplant referral criteria using predictors of 2-year mortality . Am J Respir Crit Care Med . 2002;166:1550–1555
  39. Hayllar KM , Williams SG , Wise AE , et al.   A prognostic model for the prediction of survival in cystic fibrosis . Thorax . 1997;52:313–317
  40. Sharma R , Florea VG , Bolger AP , et al.   Wasting as an independent predictor of mortality in patients with cystic fibrosis . Thorax . 2001;56:746–750
  41. Ellaffi M , Vinsonneau C , Coste J , et al.   One-year outcome after severe pulmonary exacerbation in adults with cystic fibrosis . Am J Respir Crit Care Med . 2005;171:158–164
  42. Rosenbluth DB , Wilson K , Ferkol T , Schuster DP . Lung function decline in cystic fibrosis patients and timing for lung transplantation referral . Chest . 2004;126:412–419
  43. Davis PB . The gender gap in cystic fibrosis survival . J Gend Specif Med . 1999;2:47–51
  44. Venuta F , Rendina EA , Rocca GD , et al.   Pulmonary hemodynamics contribute to indicate priority for lung transplantation in patients with cystic fibrosis . J Thorac Cardiovasc Surg . 2000;119:682–689
  45. Grover FL , Barr ML , Edwards LB , et al.   Thoracic transplantation . Am J Transplant . 2003;3(Suppl 4):91–102
  46. Flaherty KR , Travis WD , Colby TV , et al.   Histopathologic variability in usual and nonspecific interstitial pneumonias . Am J Respir Crit Care Med . 2001;164:1722–1727
  47. Monaghan H , Wells AU , Colby TV , du Bois RM , Hansell DM , Nicholson AG . Prognostic implications of histologic patterns in multiple surgical lung biopsies from patients with idiopathic interstitial pneumonias . Chest . 2004;125:522–526
  48. Flaherty KR , Toews GB , Travis WD , et al.   Clinical significance of histological classification of idiopathic interstitial pneumonia . Eur Respir J . 2002;19:275–283
  49. Katzenstein AL , Fiorelli RF . Nonspecific interstitial pneumonia/fibrosis. Histologic features and clinical significance . Am J Surg Pathol . 1994;18:136–147
  50. Travis WD , Matsui K , Moss J , Ferrans VJ . Idiopathic nonspecific interstitial pneumonia: prognostic significance of cellular and fibrosing patterns: survival comparison with usual interstitial pneumonia and desquamative interstitial pneumonia . Am J Surg Pathol . 2000;24:19–33
  51. Latsi PI , du Bois RM , Nicholson AG , et al.   Fibrotic idiopathic interstitial pneumonia (the prognostic value of longitudinal functional trends) . Am J Respir Crit Care Med . 2003;168:531–537
  52. Jegal Y , Kim DS , Shim TS , et al.   Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia . Am J Respir Crit Care Med . 2005;171:639–644
  53. Alhamad EH , Lynch JP , Martinez FJ . Pulmonary function tests in interstitial lung disease (what role do they have?) . Clin Chest Med . 2001;22:715–750 ix
  54. King TE , Safrin S , Starko KM , et al.   Analyses of efficacy end points in a controlled trial of interferon-gamma1b for idiopathic pulmonary fibrosis . Chest . 2005;127:171–177
  55. Flaherty KR , Mumford JA , Murray S , et al.   Prognostic implications of physiologic and radiographic changes in idiopathic interstitial pneumonia . Am J Respir Crit Care Med . 2003;168:543–548
  56. Collard HR , King TE , Bartelson BB , Vourlekis JS , Schwarz MI , Brown KK . Changes in clinical and physiologic variables predict survival in idiopathic pulmonary fibrosis . Am J Respir Crit Care Med . 2003;168:538–542
  57. Martinez FJ , Safrin S , Weycker D , et al.   The clinical course of patients with idiopathic pulmonary fibrosis . Ann Intern Med . 2005;142:963–967
  58. Collard HR , King TE . Demystifying idiopathic interstitial pneumonia . Arch Intern Med . 2003;163:17–29
  59. Mogulkoc N , Brutsche MH , Bishop PW , Greaves SM , Horrocks AW , Egan JJ . Pulmonary function in idiopathic pulmonary fibrosis and referral for lung transplantation . Am J Respir Crit Care Med . 2001;164:103–108
  60. Fartoukh M , Humbert M , Capron F , et al.   Severe pulmonary hypertension in histiocytosis X . Am J Respir Crit Care Med . 2000;161:216–223
  61. Erbes R , Schaberg T , Loddenkemper R . Lung function tests in patients with idiopathic pulmonary fibrosis. Are they helpful for predicting outcome? . Chest . 1997;111:51–57
  62. Miki K , Maekura R , Hiraga T , et al.   Impairments and prognostic factors for survival in patients with idiopathic pulmonary fibrosis . Respir Med . 2003;97:482–490
  63. Gay SE , Kazerooni EA , Toews GB , et al.   Idiopathic pulmonary fibrosis (predicting response to therapy and survival) . Am J Respir Crit Care Med . 1998;157:1063–1072
  64. Lama VN , Flaherty KR , Toews GB , et al.   Prognostic value of desaturation during a 6-minute walk test in idiopathic interstitial pneumonia . Am J Respir Crit Care Med . 2003;168:1084–1090
  65. Douglas WW , Ryu JH , Schroeder DR . Idiopathic pulmonary fibrosis (impact of oxygen and colchicine, prednisone, or no therapy on survival) . Am J Respir Crit Care Med . 2000;161:1172–1178
  66. Raghu G , Brown KK , Bradford WZ , et al.   A placebo-controlled trial of interferon gamma-1b in patients with idiopathic pulmonary fibrosis . N Engl J Med . 2004;350:125–133
  67. Selman M , Thannickal VJ , Pardo A , Zisman DA , Martinez FJ , Lynch JP . Idiopathic pulmonary fibrosis (pathogenesis and therapeutic approaches) . Drugs . 2004;64:405–430
  68. Morgan C , Knight C , Lunt M , Black CM , Silman AJ . Predictors of end stage lung disease in a cohort of patients with scleroderma . Ann Rheum Dis . 2003;62:146–150
  69. Steen VD , Conte C , Owens GR , Medsger TA . Severe restrictive lung disease in systemic sclerosis . Arthritis Rheum . 1994;37:1283–1289
  70. Rosas V , Conte JV , Yang SC , et al.   Lung transplantation and systemic sclerosis . Ann Transplant . 2000;5:38–43
  71. D’Alonzo GE , Barst RJ , Ayres SM , et al.   Survival in patients with primary pulmonary hypertension. Results from a national prospective registry . Ann Intern Med . 1991;115:343–349
  72. Hopkins WE , Ochoa LL , Richardson GW , Trulock EP . Comparison of the hemodynamics and survival of adults with severe primary pulmonary hypertension or Eisenmenger syndrome . J Heart Lung Transplant . 1996;15:100–105
  73. Badesch DB , Tapson VF , McGoon MD , et al.   Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease. A randomized, controlled trial . Ann Intern Med . 2000;132:425–434
  74. Kawut SM , Taichman DB , Archer-Chicko CL , Palevsky HI , Kimmel SE . Hemodynamics and survival in patients with pulmonary arterial hypertension related to systemic sclerosis . Chest . 2003;123:344–350
  75. Miyamoto S , Nagaya N , Satoh T , et al.   Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing . Am J Respir Crit Care Med . 2000;161:487–492
  76. Sitbon O , Humbert M , Nunes H , et al.   Long-term intravenous epoprostenol infusion in primary pulmonary hypertension (prognostic factors and survival) . J Am Coll Cardiol . 2002;40:780–788
  77. McLaughlin VV , Shillington A , Rich S . Survival in primary pulmonary hypertension (the impact of epoprostenol therapy) . Circulation . 2002;106:1477–1482
  78. Wensel R , Opitz CF , Anker SD , et al.   Assessment of survival in patients with primary pulmonary hypertension (importance of cardiopulmonary exercise testing) . Circulation . 2002;106:319–324
  79. Shorr AF , Davies DB , Nathan SD . Outcomes for patients with sarcoidosis awaiting lung transplantation . Chest . 2002;122:233–238
  80. Arcasoy SM , Christie JD , Pochettino A , et al.   Characteristics and outcomes of patients with sarcoidosis listed for lung transplantation . Chest . 2001;120:873–880
  81. Shorr AF , Helman DL , Davies DB , Nathan SD . Pulmonary hypertension in advanced sarcoidosis (epidemiology and clinical characteristics) . Eur Respir J . 2005;25:783–788
  82. Kitaichi M , Nishimura K , Itoh H , Izumi T . Pulmonary lymphangioleiomyomatosis (a report of 46 patients including a clinicopathologic study of prognostic factors) . Am J Respir Crit Care Med . 1995;151:527–533
  83. Taylor JR , Ryu J , Colby TV , Raffin TA . Lymphangioleiomyomatosis. Clinical course in 32 patients . N Engl J Med . 1990;323:1254–1260
  84. Johnson SR , Tattersfield AE . Decline in lung function in lymphangioleiomyomatosis (relation to menopause and progesterone treatment) . Am J Respir Crit Care Med . 1999;160:628–633
  85. Boehler A , Speich R , Russi EW , Weder W . Lung transplantation for lymphangioleiomyomatosis . N Engl J Med . 1996;335:1275–1280
  86. Delobbe A , Durieu J , Duhamel A , Wallaert B  Groupe d’Etude en Pathologie Interstitielle de la Societe de Pathologie Thoracique du Nord . Determinants of survival in pulmonary Langerhans’ cell granulomatosis (histiocytosis X) . Eur Respir J . 1996;9:2002–2006
  87. Vassallo R , Ryu JH , Schroeder DR , Decker PA , Limper AH . Clinical outcomes of pulmonary Langerhans’-cell histiocytosis in adults . N Engl J Med . 2002;346:484–490

PII: S1053-2498(06)00251-8

doi: 10.1016/j.healun.2006.03.011

The Journal of Heart and Lung Transplantation
Volume 25, Issue 7 , Pages 745-755 , July 2006