Lung Conditions That Can Lead to Transplant at Tampa General Hospital

Transparent man showing lungsA lung transplant can be recommended as a treatment for many conditions that lead to lung failure. These conditions prevent the lungs from efficiently transferring oxygen into the blood and moving carbon dioxide out of the blood, causing many complications. Tampa General Hospital’s Lung Transplant Program specializes in helping adults who need lung transplants, and patients in the program experience some of the shortest times to transplant in the nation; 50 percent of patients are transplanted within 5.4 months of listing, according to the latest data released in July 2015 from the Scientific Registry of Transplant Recipients. Our lung transplant team can address several lung conditions, including:

Cystic fibrosis – An inherited disease of the mucus-producing glands; it causes them to produce thick, sticky mucus that can clog airways and foster bacterial growth that can lead to infections. This is one of the conditions TGH specializes in for lung transplant procedures. Criteria for transplant for this form of lung fibrosis include:

  • FEV1 < 30%
  • Rapid declining FEV1
  • PAO2 < 50 or PCO2 > 55
  • Weight loss
  • cardiothoracic referral form buttonMassive hemoptysis
  • Refractory or recurrent pneumothorax
  • Frequent hospitalizations

Pulmonary fibrosis – Another of the lung transplant conditions which TGH specializes in, this is a disease characterized by formation of scar tissue within the lungs. The thickened tissue makes the lungs less efficient at transferring gases into and out of the blood, depriving organs of oxygen. Criteria for transplant include:

  • FVC <70% = 2 year survival of 50%
  • FVC <60% = 2 year survival of 20%
  • DLCO <50%
  • Hypoxemia
  • Poor performance status
  • Desaturation on exercise

Chronic obstructive pulmonary disease (COPD) – A progressive pulmonary disease that makes breathing more difficult. Most people who have COPD have both emphysema and chronic bronchitis. Conditions for lung transplant include:

  • BODE Index exceeding 5
  • FEV1 < 25% or PCO2 > 55 or resting hypoxemia
  • Pulmonary hypertension or corpulmonale
  • Deteriorating clinical course

Lymphangioleiomyomatosis (LAM) – A rare lung disease that causes rapid growth of abnormal cells within the lungs, typically in women. These cells can crowd out the normal cells, making it more difficult to complete gas transfer in the lungs. Criteria for transplant include:

  • NYHA Functional Class III or IV
  • Hypoxemia at rest
  • Severe impairment in lung function and exercise (VO2 <50% predicted)

Primary pulmonary hypertension – A condition involving higher-than-average pressure in the pulmonary arteries, an issue that makes it harder for the heart to pump blood through the blood vessels. It can strain the heart and causes shortness of breath, fainting spells, and other symptoms. Criteria for transplant include:

  • NYHA functional class III or IV, irrespective of ongoing therapy
  • Low (<350 meter) or declining 6 MWT
  • Cardiac index < 2 L per min/M2
  • Right atrial pressure >15 mmHg
  • Poor survival without treatment (eg. epoprostenol)

Sarcoidosis – A disease that spurs the formation of immune cell clusters called granulomas in various organs, including the lungs. The resulting damage can reduce the function of affected organs. Conditions for lung transplant include:

  • NYHA functional class III or IV
  • Hypoxemia at rest
  • Pulmonary hypertension
  • Right atrial pressure >15mmHg

The diagnosis of one of these conditions doesn’t necessarily mean that a patient should be recommended for a lung transplant. Rather, more conservative treatment methods such as taking medications, making lifestyle changes (like quitting smoking), exercising, and participating in physical therapy can all be used to manage symptoms of these diseases. If the symptoms become too severe to control with these approaches, physicians may recommend that their patients be referred to Tampa General Hospital’s Lung Transplant Program for evaluation of their conditions.