Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation

Lorriana E. Leard*, Are M. Holm, Maryam Valapour, Allan R. Glanville, Sandeep Attawar, Meghan Aversa, Silvia V. Campos, Lillian M. Christon, Marcelo Cypel, Göran Dellgren, Matthew G. Hartwig, Siddhartha G. Kapnadak, Nicholas A. Kolaitis, Robert M. Kotloff, Caroline M. Patterson, Oksana A. Shlobin, Patrick J. Smith, Amparo Solé, Melinda Solomon, David WeillMarlies S. Wijsenbeek, Brigitte W.M. Willemse, Selim M. Arcasoy, Kathleen J. Ramos

*Corresponding author for this work

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Tens of thousands of patients with advanced lung diseases may be eligible to be considered as potential candidates for lung transplant around the world each year. The timing of referral, evaluation, determination of candidacy, and listing of candidates continues to pose challenges and even ethical dilemmas. To address these challenges, the International Society for Heart and Lung Transplantation appointed an international group of members to review the literature, to consider recent advances in the management of advanced lung diseases, and to update prior consensus documents on the selection of lung transplant candidates. The purpose of this updated consensus document is to assist providers throughout the world who are caring for patients with pulmonary disease to identify potential candidates for lung transplant, to optimize the timing of the referral of these patients to lung transplant centers, and to provide transplant centers with a framework for evaluating and selecting candidates. In addition to addressing general considerations and providing disease specific recommendations for referral and listing, this updated consensus document includes an ethical framework, a recognition of the variability in acceptance of risk between transplant centers, and establishes a system to account for how a combination of risk factors may be taken into consideration in candidate selection for lung transplantation.

Original languageEnglish
Pages (from-to)1349-1379
Number of pages31
JournalJournal of Heart and Lung Transplantation
Issue number11
Publication statusPublished - 1 Nov 2021

Bibliographical note

Funding Information:
The authors would like to thank Megan Barrett for providing administrative support for every step of the process, from the invitation of the authors until the final approval by the Board of Directors. The authors also thank the expert reviewers and the members of the ISHLT for providing their valuable input on the manuscript while in preparation.

Funding Information:
No specific funding was available for this project. During this project, the following authors reported the listed financial activities, all outside the submitted work. Selim Arcasoy received funding from the Cystic Fibrosis Foundation, the Center for Medicare and Medicaid Services, Therakos, and Zambon SpA. Lillian Christon was a psychologist representative on the Cystic Fibrosis Foundation Cystic Fibrosis-Specific Post-Transplant Consensus Guidelines Committee. Marcelo Cypel received personal fees from Lung Bioengineer and non-financial support from Gilead. Göran Dellgren received grants from Astellas Europe for ScanCLAD study ( Identifier: NCT02936505), grants from Abbott Europe for SweVAD study ( Identifier: NCT02592499), and personal fees from XVIVO AB. Allan Glanville was the chair of the data safety monitoring board for Zambon SpA. Matthew Hartwig received grants from Mallinckrodt, Transmedics, and Lung Bioengineering; and consulting fees from Paragonix, and Biomedinnovations. Nicholas Kolaitis received consulting and advisory board fees from United Therapeutics and advisory board fees from Bayer. Kathleen Ramos received grants from the Cystic Fibrosis Foundation and from the National Institutes of Health. Patrick Smith received grants from the National Institutes of Health, the Cystic Fibrosis Foundation, and the Boomer Esiason Foundation. Melinda Solomon received grants and an honorarium from Vertex pharmaceuticals. Maryam Valapour received grants from the National Institutes of Health, the Health Resources and Services Administration, the Department of Health and Human Services, and from the Cystic Fibrosis Foundation. David Weill was a Board Member for TransMedics. Marlies Wijsenbeek received grants from Boehringer Ingelheim, Hoffman la Roche, The Netherlands Organisation for Health Research and Development, The Dutch Lung Foundation, The Dutch Pulmonary Fibrosis Patient Association, The Thorax Foundation, Erasmus MC,; received other funding from Novartis, Bristol Myers Squibb, Galecto, and Respivant; participated on a Data Safety Monitoring Board for Savara, and Galapagos; and served as Secretary of the Idiopathic Interstitial Pneumonia group of the European Respiratory Society, a member of the Board of the Netherlands Respiratory Society, and a member of the scientific advisory board of the European Idiopathic Pulmonary Fibrosis and related disorders federation. The funding sources listed for each author were outside the scope of the submitted work and had no role in the consensus statements or the writing of the manuscript. The remaining authors had no financial disclosures.

Publisher Copyright:
© 2021 The Authors


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