Lung Transplant (pathology)

Question 1

What are the criteria to be met for lung transplants?

Answer 1

• Age < 65
• Not overweight
  
  • Post op prednisolone ↑ weight gain
• Not diabetic
• No renal failure (cyclosporin worsens renal failure)
• No mental illness
• Good social support

If fails cannot attempt again

Question 2

Indications for double lung transplant in CF

Answer 2

Prolongs life (not a cure)

• Rapid decline in lung function
• FEV1<30% predicted
• Life threatening exacerbations
• Estimated survival < 2y.
• Recurrent pneumothorax, haemoptysis

Question 3

Contra-indications for double lung transplant in CF

Answer 3

• Other organ failure (esp. renal failure- cyclosporin worsens renal failure)
• Non tuberculous mycobacteria
• Burkholderia cepacia
• Malignancy within 5 y.
• Severe PVD
• Drug, nicotine, alcohol dependency

Question 4

When may single lung transplant in pulmonary fibrosis be indicated?

Answer 4

• If idiopathic or Hamman-Rich syndrome (cryptogenic fibrosing alveolitis)
• Emphysema-> single lung transplant
• In alpha 1 antitrypsin deficiency