Evaluation of patients referred for lung transplantation: fourteen years experience

We present a descriptive study of patients referred as candidates for lung transplantation in the last 14 years. The 837 requests were evaluated stepwise in three phases: phase I, derivation report; phase II, outpatient evaluation; and phase III, inpatient evaluation. Chronic obstructive pulmonary disease was the most common reason for referral (31%). Cystic fibrosis was the referral disease with the best transplanted/referred relation (57%) and pulmonary fibrosis was the disease that had the highest mortality (39.7% of all deaths). Forty-three percent of all patients reached phase III and 29% were transplanted. Mortality on the waiting list was 3.7%. The most important causes of exclusion were inadequate indications and the presence of severe associated diseases. The mean study was 44 days. Knowledge of the natural history, local factors that influence organ availability, expected time on the waiting list, and disease progression allow optimization of this therapeutic option.