The Importance of Early Referrals for Lung Transplant

For patients with advanced lung disease, a transplant may be the only long-term treatment option. However, determining the right time to refer a patient for a lung transplant evaluation can be a challenge. 

Early referral is critical to determining the feasibility of a transplant and optimizing co-morbidities to improve the likelihood of a successful outcome.

At UPMC, our team is dedicated to caring for patients with traditional to complex lung conditions, which is why we encourage physicians to refer patients early — before their disease progresses, their overall health declines, and their chances of being a suitable candidate for lung transplantation decreases. 

“Late referral is a persistent problem, especially with pulmonary fibrosis patients,” explains Elizabeth Lendermon, MD, a pulmonologist and associate director of the UPMC Lung Transplant Program. “We can provide them with high-flow oxygen, but often, the dying process is already underway when they get to us.”

Idiopathic pulmonary fibrosis (IPF) is the most common form of pulmonary fibrosis in adult patients, but there currently aren’t ideal forms of treatment. Additionally, IPF progression is highly variable from patient to patient, making it difficult to predict when a transplant may be needed. Patients may be okay one week and critically ill the next.

That’s why it’s important for physicians to make a referral as soon as they make a diagnosis of pulmonary fibrosis.

“We don’t want referring physicians to have to bear the burden of deciding if their patient is a candidate for transplant,” Dr. Lendermon says. “Our team at UPMC will evaluate the patient and make that determination. And we don’t mind them coming in too early. If it’s not yet time for a transplant, we will partner with the physician to develop an alternative treatment plan that fits the patient’s needs.”

There are several preparations required before a transplant can be performed including a variety of tests and discussions about topics such as insurance, support systems, and travel arrangements. Medications and cardiac stents may be required as well.

“Even if patients have to wait for a transplant, they are at such an advantage if we get this work completed ahead of time,” Dr. Lendermon says. “If necessary, we can monitor them for years, and if their condition gets worse, things can happen rapidly, but we’ll be ready.”

In addition to pulmonary fibrosis, other common conditions in patients transplanted at UPMC include primary pulmonary hypertension, cystic fibrosis, and chronic obstructive pulmonary disease (COPD).

The UPMC Lung Transplant Program is one of the most recognized and experienced centers in the world for lung and combined heart-lung transplantation. Our experts are available to discuss your patients to determine if they are appropriate for a lung transplant evaluation. We accept many high-risk patients that other centers may decline. 

To refer a patient or request a consultation, call UPMC’s 24-hour physician referral service at 1-844-LUNG-UPMC.