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Table 12.2. Contraindications to lung transplantation
Absolute
Acutely ill/unstable
Uncontrolled tuberculosis
Uncontrolled sepsis Uncontrolled neoplasm Current smoker Psychosocial problems Inadequate resources HIV infection Irreversible CNS injury
Relative
Systemic diseases with failure of nonpulmonary vital organs
Cardiac disease (coronary artery disease, ventricular dysfunction Ongoing high-dose corticosteroids Age >65 years
Unsatisfactory nutritional status Osteoporosis Medical noncompliance Mechanical ventilation
Table 12.3. Scheme for evaluation of potential lung transplant recipients
• Medical history and physical examination
• Chest radiograph, electrocardiogram, and routine blood chemistries
• ABO blood typing, HLA typing and panel of reactive antibodies
• Serologic tests for hepatitis A, B, and C; HIV, cytomegalovirus
• Pulmonary studies
- Standard pulmonary function testing, arterial blood gases
- Quantitative ventilation/perfusion scanning
- Cardiopulmonary exercise testing
- CT of the chest
• Cardiovascular Studies
- Radionuclear ventriculography
- Doppler echocardiography (with saline contrast)
- Right heart catheterization with angiography
- Transesophageal echocardiography
• Rehabilitation Assessment
- Six-minute walk test
- Determination of supplemental oxygen requirements
• Psychosocial Evaluation
• Nutritional Assessment

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