Table 2.

Recommendations for referral and work up for lung transplantation in patients with fibrotic lung diseases.

Timing of referral

At diagnosis of UIP Any form of fibrosis with FVC < 80% or DLCO < 40% Any form of fibrosis with Relative decline in FVC ≥ 10% Relative decline in DLCO ≥ 15% Relative decline in FVC ≥ 5% in combination with worsening of respiratory symptoms or radiographic progression Use of supplemental oxygen

Timing of listing

Any form of pulmonary fibrosis with one of the following in the past 6 months despite treatment: Absolute decline in FVC > 10% Absolute decline in DLCO > 10% Absolute decline in FVC > 5% with radiographic progression Desaturation to <88% on 6MWT or >50 m decline in 6 MWT distance in the past 6 months PH on RHC or two‐dimensional echocardiography (in the absence of diastolic dysfunction) Hospitalization because of respiratory decline, pneumothorax, or acute exacerbation.

Note: 6MWT, 6‐min walking test; DL_CO, diffusion of carbon monoxide; FVC, forced vital capacity; PH, pulmonary hypertension; UIP, usual interstitial pneumonia.

Source: Adopted from Leard et al. Consensus document for the selection of lung transplant candidates: an update from the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2021; 40(11):1349–1379. ¹¹⁴