To refer a patient for lung transplant evaluation, please call 1-855-EMORY-TX (855-366-7989), Mon–Fri 8 a.m. – 4:30 p.m.

The following items are required for a lung transplant referral to be processed:

  • Completed Referral Form 
  • A dictated progress note or History & Physical which summarizes the patient’s course and care, and includes a complete list of relevant past medical history
  • Recent pulmonary function testing
  • Radiologic films and reports (Chest X-ray, CT of the chest, bone density studies, etc.)
  • Pathology and Operative reports, where applicable
  • Cardiac catheterization reports, where applicable
  • Patient’s smoking history and documentation of cessation, if applicable
  • Notes from any other transplant centers that have seen the patient
  • Notes from any consulting physicians that have seen the patient.
  • A signed consent to obtain outside medical records
  • Copy of front and back of patient's insurance card

These items can be faxed to 404-727-1516. Faxed referral information will be reviewed by a transplant pulmonologist. If your patient has contraindications to transplantation, the transplant pulmonologist will contact you to discuss the patient’s case.

Referral Information

  • We will partner with you to ensure the best outcome for your patient
  • Ideal candidates have a BMI >17 and <30
  • Active participation in pulmonary rehabilitation is mandatory
  • Age 16 to 65+ years (patients greater than age 65 are evaluated on a case-by-case basis)
  • Functionally limited (NYHA class III or IV) but still ambulatory with rehabilitation potential – patients hospitalized in ICU with critical or unstable clinical condition may become candidates once discharged home and ambulatory
  • Willingness to partner with the transplant team on all aspects of health
  • End-stage lung diseases without adequate response to optimal treatment
  • Predicted two-to three-year life expectancy of less than 50 percent
  • Early referral is highly desirable, particularly in idiopathic pulmonary fibrosis

All patients referred for lung transplant evaluation will be reviewed by a transplant pulmonologist. If your patient has contraindications to transplantation, the transplant pulmonologist will contact you to discuss the individual patient case. Our goal is to work with you on a collaborative basis to provide your patients with end-stage lung disease the best care available.

Referral for lung transplantation is recommended by international guidelines if patients meet any of the following criteria (The Journal of Heart and Lung Transplantation 2015, 34:1-15).

COPD

  • BODE index ≥ 6
  • Deterioration despite optimal medical and surgical therapy
  • History of hospitalization for exacerbation associated with acute hypercapnia (PCO2 exceeding 50 mm Hg)
  • Pulmonary hypertension or Cor pulmonale or both, despite oxygen therapy

Pulmonary Fibrosis

  • Histologic or radiographic evidence of UIP irrespective of vital capacity
  • Histologic evidence of fibrotic NSIP

Cystic Fibrosis

  • FEV1 below 30 percent predicted or a rapid decline in FEV1 – in particular in young female patients
  • Exacerbation of pulmonary disease requiring ICU stay
  • Increasing frequency of exacerbations requiring antibiotic therapy
  • Refractory and/or recurrent pneumothorax
  • Recurrent hemoptysis not controlled by embolization

Pulmonary Hypertension

  • NYHA functional class III or IV, irrespective of ongoing therapy
  • Rapidly progressive disease

Sarcoidosis, LAM, Eosinophilic Granuloma

  • NYHA functional class III or IV
  • Ventilator dependence
  • Recent malignancy (other than nonmelanoma skin cancer) in the past two-to-five years
  • Significant extrapulmonary vital organ dysfunction (irreversible hepatic, renal, cardiac dysfunction, bone marrow failure)
  • Severe coronary disease not amenable to intervention; severe peripheral vascular disease
  • Active infection with B. cenocepacia
  • Substance addiction (e.g., alcohol, tobacco, narcotics) – active or within the last six months
  • Severe psychiatric illness
  • Inability to cooperate or comply with medical therapy
  • Lack of adequate social support