This is one of the most common questions that comes up, and it's sometimes not the easiest question to answer because each transplant hospital will have slightly different criteria, and each of you is unique.
I guess the first thing to say is that the #1 requirement is that you have to be sick enough to warrant a lung transplant, and at the same time healthy enough that your body can recover from it. What this means is that if you aren't terminally ill with progressive lung disease, or you're generally incredibly ill with other comorbidities (conditions that greatly reduce your lifespan), then it's highly unlikely you will be approved for transplant at this time.
Generally speaking, these are the basic requirements:
- Maximum age of about 70 (I have heard that some centers are accepting people who are otherwise very healthy who are upwards of 75 years old)
- BMI under 30 (calculate your BMI here https://www.nhlbi.nih.gov/calculate-your-bmi)
- No recent cancer or cancer treatment (5 years cancer free is what I seem to see)
- No major diseases such as HIV
- No active drug/tobacco/alcohol use (if you can't quit, you can't be transplanted, and they will test you regularly!)
- Liver/Kidney and other organs need to be in generally good condition
- You need to be able to somehow pay for the surgery and all the follow up care
- You need to have a dedicated caregiver (family member, etc) who can live with you for 90 days after your surgery--you can't do this solo or with someone to stop by and check on you every day!
- Be mentally sound (this is a major, life changing operation that requires strict adherence to medications and lifestyle changes)
If you read this and are immediately depressed because you don't fit one of these, please call a transplant center (here's our list of centers in the USA) or two and talk to them before giving up. Every single day there's advancements in science and medicine, and they're transplanting people today who would have been denied a few years ago. But, if you're greatly outside of the requirements, say if you're 90 years old, it's unlikely you will find a center that will perform a lung transplant. If your BMI is 31 but you're otherwise healthy, the center might give an exception because this list is not written in stone, nor does it apply to every center.
But I always stress that lung transplantation is hard on your body and mind, and both need to be fit enough to get through it, and to deal with it hopefully for many many years to come. Beyond the transplant, some of the medications are just plain old not good for you, they're hard on your body and oftentimes have side effects. You need to take these medications, typically several times per day, otherwise you will die.
Transplant can be hard on your mind for many reasons. I'm breathing right now from lungs that came from another person that passed away, I've been to the clinic or hospital for appointments probably 100 times in the last 14 months since my surgery, I have to constantly think "hmmm, can I eat that or does it have a higher risk of making me sick?" or "Can I do that task, or will it have a higher risk of making me sick?" I am fortunate to live in an apartment with a nice outdoor hot tub and a sauna, they're well maintained, I see them every day from my window, and before my surgery I used them nearly every single day, and now I am banned for life from them because the risk of a serious infection is extremely high. Large social events are also extremely risky, so it's extremely rare that I attend one, and if I do, I'm that guy with the mask trying to avoid shaking hands, hugging, etc.
In the grand scheme of things, these are all small, petty problems that are sacrificed so that I can be here today. It's easy to go to the clinic for 2 hours for a simple checkup, it's easy to avoid certain foods and situations, but all of this adds up and can be quite difficult for even the most mentally resilient person to handle.
But I can say, it's all very much worth it. I've never met a single person who didn't regret having a lung transplant!
I hope this article helped you. If you're discouraged, don't give up until you've exhausted all your options!
Here are some more detailed requirements of other lung transplant centers:
https://www.hopkinsmedicine.org/transplant/referring-physicians/lung-transplant-criteria
https://my.vanderbilthealth.com/am-i-a-candidate-for-a-lung-transplant/
https://columbiasurgery.org/lung-transplant/evaluation-lung-transplant-surgery
https://www.templehealth.org/services/treatments/lung-transplant/criteria
https://www.thoracic.org/patients/patient-resources/resources/recipient-selection-transplantation.pdf
