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Contraindications


                                                                                  Lung Transplantation: Version 7.0

Contraindications


Solid Organ Transplantation: General Contraindications
        • Active infection
        • Malignant disease - patients should be tumor-free for at least five years
          prior to consideration for transplantation (this may vary by center)
        • HIV (this may vary by center)
        • Active peptic ulcer disease
        • Active drug, tobacco or alcohol abuse
        • Severe, irreversible organ system damage other than organ to be
          transplanted
        • Evidence of psychopathology
        • Inability to understand the procedure or the risks involved or comply
          with follow-up care
        • History of failure to comply with medical regimen
        • Lack of functional psychosocial support system
        • Lack of financial resources to pay for surgery, hospitalizations,
          medications and follow-up care

Lung Transplantation: Absolute Contraindications
        • Age  > 65 for single-lung, > 55 for bilateral lung, > 45 for heart-lung
        • Corticosteroid dependency  > 20 mg of prednisone or equivalent per day
        • Significant, untreatable coronary artery disease - greater than one vessel
          coronary artery disease
        • Cardiac insufficiency - right or left ventricular ejection fraction < 20 percent
        • Dependent on mechanical ventilation and clinically unstable
        • Significant infection present outside the lungs and upper respiratory tract
        • Obesity - body weight > 140 percent predicted
        • Cachexia - body weight < 80 percent predicted
        • Active systemic collagen vascular disease
        • No rehabilitative pulmonary disability
        • Creatinine clearance < 50mg/ml/min
        • Bleeding diathesis
        • Surgically remediable chronic thromboembolic disease
        • Complicated or uncontrolled diabetes mellitus
        • Significantly impaired hepatic function with persistent marked elevation of
          liver function tests
        • Hepatitis B virus antigen positive (surface, core or both - this may vary by center)
        • Hepatitis C virus infection with biopsy-proven evidence of liver disease