Indications

The primary indication for lung transplantation is irreversible end-stage pulmonary disease expected to result in death within 1to 2 years and for which there are no other treatment options. Clinical conditions for which lung transplantation is indicated include the following:

1. Obstructive lung disease/Emphysema

Chronic obstructive pulmonary disease (COPD)

Alpha-1-antitrypsin deficiency

2. Restrictive lung disease

Idiopathic pulmonary fibrosis (IPF)

3. Pulmonary vascular disease

Primary pulmonary hypertension (PPH)

Eisenmenger's syndrome (ES)

4. Septic lung disease

Cystic fibrosis (CF)

Other "miscellaneous" causes of end-stage lung disease that have been treated with lung transplantation include cystic lung diseases such as sarcoidosis, lymphangioleiomyomatosis, and histiocytosis-X; chemotherapy or radiation therapy induced pulmonary fibrosis, idiopathic bronchiectasis, and obliterative bronchiolitis (OB) as a manifestation of chronic rejection following lung transplantation. The leading indications for lung transplantation between 1995 and 2001 were COPD (39.4%), IPF (16.9%), CF (16.1%), alpha-1-antitrypsin deficiency emphysema (9.3%) and PPH (4.6%).1

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