Table 2. Prerequisites for organ recipients and donors.

a) Basic diagnostic criteria for attendance at transplantation center
History		Diagnosis, disease course, any concomitant disease(s)
Current status		Height, weight, exercise capacity (6MWT), requirement for oxygen therapy, noninvasive ventilation, edema
Recent pulmonary function		Body plethysmography
Arterial blood gas analysis		Resting and – if possible – during exercise (alternatively, oxygen saturation after 6MWT)
Basic laboratory values		Complete blood count, differential blood count, coagulation, renal function (cystatin C, creatinine clearance), liver function, Quick test value, determination of blood group and HLA, cytotoxic antibodies (for recipients with autoimmunization), electrophoresis, immunglobulins
Recent echocardiography		To assess right ventricle (systolic right ventricular pressure)
Abdominal ultrasound		To assess abdominal organs
Recent chest CT (≤ 6 months)		High-resolution in patients with interstitial lung disease
Dental examination		To exclude focus of infection
ENT examination		To exclude focus of infection (especially in patients with bronchiectasis, cystic fibrosis)
Psychosocial status		Social environment, adherence with therapy so far
b) Further investigations as required by the transplantation center before acceptance onto waiting list
Special laboratory tests		Immunglobulins, IgG subclasses, lymphocyte populations, viral serology (HIV, HBV, HCV)
Recent sputum culture		Bronchiectasis, necrotizing lung disease
Duplex sonography of extracranial arteries		>45 years (smokers: >40 years)
Gynecological and urological check-up		Irrespective of age
Peripheral capillary wedge pressure; duplex sonography of pelvic and leg arteries if required		>45 years (smokers: >40 years)
Ventilation–perfusion scintigraphy		Quantitative, separately for each side (only when SLuTx is planned)
Recent right heart catheter		RA, PAP, PCWP, PVR,CO (thermodilution)
Left heart catheter or coronary angiography		>45 years (smokers: >40 years) or risk factors for coronary heart disease, in patients in whom the presence of an unrecognized defect is suspected
Colonoscopy		In patients >50 years and those with diverticulosis
c) Basic prerequisites for organ donors
Minimum criteria (selection)		Age <55 years; blood group compatibility; pao2 >300 mmHg with FiO2 1.0 and PEEP 5 mmHg; normal chest X-ray and bronchoscopy; exclusion criteria: malignant tumor, chest trauma, sepsis
Extended criteria (selection)		Age >55 years; radiological suspicion of infiltrates; suspected aspiration; abnormal bronchial secretion; chest trauma

Brain death leads to a series of hemodynamic and inflammatory changes (including a rise in interleukin-8 and increased neutrophil infiltration) that result in tissue damage and abnormal fluid balance. For this reason, organ donor management in the intensive care unit is extremely important. Because the donor criteria have been expanded, according to Eurotransplant data the percentage of lungs harvested has gone up from 16.7% in 2003 to 27.1% in 2012. Nonetheless, the majority of multiorgan donors do not meet the criteria and lung donation fails. 6MWT, 6-minute walk test; IgG, immunoglobulin G; HIV, human immunodeficiency virus; HBV, hepatitis B virus; HCV, hepatitis C virus; SLuTx, single lung transplantation; RA, right atrium; PAP, pulmonary arterial pressure; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; CO, cardiac output; paO2, arterial partial oxygen pressure; FiO2, fraction of inspired oxygen; PEEP, positive end-expiratory pressure

Table adapted from [e18]