Chapter 29. Lung Transplantation

Stephanie M Levine, MD, FCCP
DOI: 10.1378/pulm.26.29
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  • Define the indications for lung transplantation.

  • Review the guidelines for recipient selection for lung transplantation.

  • Describe the relative and absolute contraindications to lung transplantation.

  • Describe outcomes following transplantation, including survival and physiologic results.

  • Review the complications following lung transplantation.

  • Provide an overview of the immunosuppressive medications used in lung transplantation.


Lung transplantation is now a well-accepted therapeutic option for the treatment of end-stage lung disease. Indications for lung transplantation include idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, cystic fibrosis, and pulmonary hypertension, among others. Following transplantation, complications can develop, including primary graft dysfunction, infection, and rejection. Although survival rates of lung transplant recipients have improved over the years, they still remain lower than survival rates for other solid organ transplant recipients. The leading factor preventing long-term survival is the development of chronic rejection. The development of better strategies for preventing and treating rejection and infection has allowed significant advancements in the field of lung transplantation. All phases of lung transplantation including the indications; evaluation; new donor allocation system; outcomes; and complications including graft dysfunction, acute and chronic rejection, infection, and complications related to immunosuppression will be reviewed.


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