Lung Transplant Referral Form 2025

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Indications Cystic fibrosis. Bronchiectasis. Pulmonary hypertension. Emphysema. Pulmonary fibrosis (idoiopathic or secondary to scleroderma or other disease states)
The transplant team will consider all information from interviews, your medical history, physical exam, and diagnostic tests in deciding your eligibility for a lung transplant. Once you have been accepted as a transplant candidate, you will be placed on a waiting list of the United Network for Organ Sharing (UNOS.)
Increasing Your Eligibility for a Lung Transplant Avoiding alcohol and drugs. Documenting that you have not used any nicotine product for at least six months, including vaping. Maintaining a BMI (body mass index) of 35 or less. Securing a strong social network to support you before, during and after lung transplantation.
Common reasons why a lung transplant may not be the right treatment for you include: You are too ill or frail to cope with the surgery and aftercare. You have recently had cancer, a serious infection, a heart attack or a stroke. You may struggle taking the immunosuppressant medicines after a lung transplant.
You must: Be physiologically 60 years of age or less for a double lung transplant and 65 years of age or less for a single lung transplant. Have a poor prognosis, with a life expectancy of 18 to 24 months. Not have any other life-threatening systemic disease.
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