ALPF Medical Research

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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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