To refer a patient for lung transplant evaluation, please call 1-855-366-7989, 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.
  • Signed consent to obtain outside medical records
  • Copy of front and back of the 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 Guidelines

  • 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
     

Eligibility Criteria

  • 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
     

Referral Process

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.
 

Disease-Specific Guidelines

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
     

Relative Contradictions for 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
  • 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