Unless significant contraindications exist, lung transplantation should be considered for patients with end-stage disease who meet selection criteria. Guidelines for the timing of referral for transplantation include evidence of usual interstitial pneumonia and:
Diffusing capacity < 40% of predicted
Forced vital capacity < 80% of predicted
Any dyspnea or functional limitation attributable to lung disease
A decrease in pulse oximetry < 89% saturation, even if only during exertion
Unfortunately, mortality on the waiting list is high. Clinicians should discuss palliative care and end-of-life planning with patients whose DLCO is < 50%.
Although some patients experiencing AE-IPF may require mechanical ventilation, it does not make patients eligible for referral for lung transplant.
Although CT chest scan may demonstrate worsening fibrosis, the result does not make patients eligible for referral for lung transplant. CT scans are not the sole determinants for referral for lung transplant. It is important to consider physiologic measures, as the increased fibrosis may be relatively focal and mild, and may not result in any clinically significant impairment.
Learn more about lung transplantation in IPF.
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Cite this: Guy W. Soo Hoo, Zab Mosenifar. Fast Five Quiz: Idiopathic Pulmonary Fibrosis Treatment - Medscape - Dec 13, 2022.
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