Table 4. Lung transplantation referral indications and listing for ILD (68).

Referral:

• Histopathologic or radiographic evidence of usual interstitial pneumonitis (UIP) or fibrosing non-specific interstitial pneumonitis (NSIP), regardless of lung function

• Abnormal lung function: FVC <80% predicted or diffusion capacity of the lung for carbon monoxide (DLCO) <40% predicted

• Any dyspnea or functional limitation attributable to lung disease

• Any oxygen requirement, even if only during exertion

Timing of listing:

• Decline in FVC >10% during 6-month follow-up

• Decline in DLCO >15% during 6-month follow-up

• Desaturation <88% or distance <250 m on 6MWT or >50 m decline on 6MWD over 6 months

• Pulmonary hypertension

• Hospitalization due to respiratory decline, pneumothorax, or acute exacerbations

Specific for AS & other inflammatory lung diseases referral for lung transplantation is prudent if despite a clinically indicated trial of medical therapy any of the following are present:

• Dyspnea or functional limitation

• An oxygen requirement

• Declining lung function

ILD, interstitial lung disease; FVC, forced vital capacity.