To refer a patient for lung transplant evaluation, please call 855-366-7989, Mon–Fri 8:00 a.m. to 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.

PDF Downloads

Eligibility Criteria

  • Age 16 to 70+ 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 adhere to guidelines from health care professionals
  • Early referral is highly desirable, particularly in idiopathic pulmonary fibrosis

Indications for Lung Transplant

  • End-stage lung diseases without adequate response to optimal treatment
  • Predicted two- to three-year life expectancy of less than 50%.

Absolute Contraindications for Lung Transplant

  • 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
  • Noncurable chronic extrapulmonary infection including chronic active viral hepatitis B, hepatitis C or HIV
  • Active infection with mycobacteria, B. cenocepacia (genomovar III) and B. gladioli
  • 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
  • Obesity (BMI > 30) or underweight (BMI < 17) is relative contraindication

Referral for lung transplantation is recommended by international guidelines if patients meet any of the following criteria (The Journal of Heart and Lung Transplantation 2006, 25:745-755).

COPD

• BODE index exceeding five
• 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

IPF

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

CF

• FEV1 below 30% 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

IPAH

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

Sarcoidosis, LAM, Eosinophilic Granuloma

• NYHA functional class III or IV