59. Top Consults: Lung Transplant 101

Lung transplantation serves as an increasingly successful intervention for end-stage lung disease, with interstitial lung disease (ILD) now representing the leading indication for the procedure. Experts Dr. Hannah Mannem and Dr. Meghan Aversa emphasize that early referral—ideally at the time of diagnosis for conditions like idiopathic pulmonary fibrosis—is critical to optimize patient candidacy through physical conditioning and the management of comorbidities. The transition to the Composite Allocation Score (CAS) in March 2023 marks a significant shift in organ distribution, prioritizing long-term survival and equitable access for highly sensitized patients. While transplantation offers a transformative improvement in quality of life, it necessitates a lifelong commitment to intensive medical follow-up, immunosuppression, and multidisciplinary care. Successful outcomes rely on balancing objective prognostic data with a patient's personal goals, physical resilience, and robust psychosocial support systems.