Table 1.

Indications and Contraindications for Lung Transplantation and CF-Specific Factors [17,18,20].

General Indications	-Advanced lung disease that is refractory to medical therapy -Greater than 50% mortality from lung disease without transplantation over the next two years -Greater than 80% five-year survival post-transplantation
Absolute Contraindications	-Clinical shock, disseminated infection, or HIV infection with a detectable viral load -Malignancy with high risk of recurrence or cancer-related death -Lack of interest in transplantation, evidence of persistent non-adherence to treatment -Non-pulmonary organ dysfunction -GFR less than 40 -Stroke or acute coronary syndrome within the past thirty days -Acute liver failure or cirrhosis with synthetic dysfunction -Hematologic disorders not amenable to treatment -Active substance use or dependence
Relative Contraindications	-Age greater than 70 years -Severe coronary artery disease or cerebrovascular disease -BMI greater than 35 or less than 16 kg/m2 -Severe esophageal dysmotility, chest wall deformity, or previous thoracic surgery expected to cause difficulty with post-transplant healing -Infection or colonization with highly resistant or virulent organism -Detectable hepatitis B or C viral load -Limited functional status or neurocognitive condition that may interfere with adherence to regimen after transplantation
CF-Specific Referral Criteria	-FEV1 < 50% predicted with a greater than 20% relative decline in FEV1 within one year -FEV1 < 40% predicted accompanied by: -More than two exacerbations per year requiring antibiotics -Massive hemoptysis of more than 240 mL that necessitates ICU admission or bronchial artery embolization -BMI less than 18 -FeV1 < 30% predicted -Six-minute walk test result < 400 m -Advanced CF lung disease: -Hypoxia (PaO2 < 55 mmHg) at rest or with exertion -Hypercapnia (PaCO2 > 50 mmHg) -Previous exacerbation requiring positive pressure ventilation -Pulmonary artery systolic pressure > 50 mmHg