Lung transplantation is the most advanced treatment for patients with severe diseases of the lung, such as emphysema, cystic fibrosis, pulmonary fibrosis and pulmonary hypertension, to name a few.
Since its establishment in 1991, the UCSF Lung Transplant program has grown to one of the largest lung transplant programs in the country. We have performed nearly 500 transplants total with 40 to 50 new transplants performed every year. Lung transplant remains a field with great opportunity for improved outcomes, and we are rapidly expanding our research programs in lung transplantation to accomplish this goal. Our average survival rate is not only higher than the national average, it is also higher than what is predicted for our program, given the complexity of our patients. We will continue to push the envelope in improving patient outcomes through our research and program development.
Who is a candidate for Lung Transplantation?
The most common diagnoses have been:
- Chronic Obstructive Pulmonary Disease (COPD)
- Idiopathic Pulmonary Fibrosis (IPF)
- Cystic Fibrosis (CF)
- Idiopathic Pulmonary Arterial Hyertension (PAH)
- Eisenmenger’s syndrome
- Emphysema due to Alpha-1 Antitrypsin Deficiency
Other less common indications have included:
- Lymphangioleiomyomatosis (LAM)
- Pulmonary Langerhans Cell Histiocytosis X
In general, patients with advanced pulmonary disease can be considered for lung transplantation if they meet the following guidelines:
- Untreatable advanced pulmonary disease of any etiology
- Absence of other significant medical diseases
- Substantial limitation of daily activities
- Limited life expectancy-usually less than 2 years
- Ambulatory patient with rehabilitation potential
- Acceptable nutritional status
- Satisfactory psychosocial profile and emotional support system
When should one be referred for and listed for Lung Transplantation?
In general, a patient should be referred for a lung transplantation evaluation based on functional status and life expectancy. A patient who is short of breath at rest or with minimal exertion or who has an estimated 50% chance of surviving another 2-3 years should be referred for a transplant assessment if there are no obvious contraindications.
How does the evaluation and listing process work?
The comprehensive transplant evaluation seeks to determine the ability of the patient to benefit from transplantation and to enjoy a successful outcome with long-term health.
Objectives of Evaluation Procedures
- Single lung transplantation
- Double lung transplantation
- Heart-lung transplantation
- Transplantation of lobes from living related donors
What are the expected outcomes of Lung Transplantation?
The outcome of lung transplantation can be assessed by survival and quality of life.
Survival statistics are available by center at the SRTR. The most recent report shows that 1 year and 3 year survival at UCSF is 91.5 and 71.4% respectively.
Quality of life
Several studies have documented a significant improvement in both overall and health-related quality of life after lung transplantation. In fact, UCSF is actively involved in research transplantation to better understand the components that predict whether someone has an improvement in quality of life following transplantation.