Risk factors for poor post-transplant outcomes (reproduced and modified from Leard et al. [3])
| Absolute contraindications | Risk factors with high or substantially increased risk | Risk factors |
| Malignancy with high risk of recurrence or death related to cancer | Age >70 years | Age 65–70 years |
| Glomerular filtration rate <40 mL·min−1·1.73 m−2 unless being considered for multi-organ transplant | Severe coronary artery disease that requires coronary artery bypass grafting at transplant | Glomerular filtration rate 40–60 mL·min−1·1.73 m−2 |
| Acute coronary syndrome or myocardial infarction within 30 days | Reduced left ventricular ejection fraction <40% | Mild to moderate coronary artery disease |
| Stroke within 30 days | Significant cerebrovascular disease | Severe coronary artery disease that can be treated via percutaneous coronary intervention prior to transplant |
| Liver cirrhosis with portal hypertension or synthetic dysfunction unless being considered for multi-organ transplant | Severe oesophageal dysmotility | Patients with prior coronary artery bypass grafting |
| Acute liver failure | Untreatable haematologic disorders including bleeding diathesis, thrombophilia or severe bone marrow dysfunction | Reduced left ventricular ejection fraction 40–50% |
| Acute renal failure with rising creatinine or on dialysis and low likelihood of recovery | Body mass index ≥35 kg·m−2 | Peripheral vascular disease |
| Septic shock | Body mass index <16 kg·m−2 | Severe gastro-oesophageal reflux disease |
| Active extrapulmonary or disseminated infection | Limited functional status with poor potential for post-transplant rehabilitation | Oesophageal dysmotility |
| Active tuberculosis infection | Psychiatric, psychological or cognitive conditions with potential to interfere with medical adherence without sufficient support systems | Thrombocytopenia, leukopenia or anaemia with high likelihood of persistence after transplant |
| HIV infection with detectable viral load | Unreliable support system or caregiving plan | Osteoporosis |
| Limited functional status (e.g. non-ambulatory) with poor potential for post-transplant rehabilitation | Lack of understanding of disease and/or transplant despite teaching | Body mass index 30–34.9 kg·m−2 |
| Progressive cognitive impairment | Hepatitis B or C infection with detectable viral load and signs of liver fibrosis | Body mass index 16–17 kg·m−2 |
| Repeated episodes of non-adherence without evidence of improvement | Chest wall or spinal deformity expected to cause restriction after transplant | Frailty |
| Active substance use or dependence including current tobacco use, vaping, marijuana smoking or intravenous drug use | Extracorporeal life support | Hypoalbuminaemia |
| Other severe uncontrolled medical condition expected to limit survival after transplant | Redo transplant <1 year following initial lung transplant | Poorly controlled diabetes |
| Redo transplant for restrictive chronic lung allograft dysfunction | Edible marijuana use | |
| Redo transplant for antibody mediated rejection | HIV infection with undetectable viral load | |
| Previous thoracic surgery | ||
| Prior pleurodesis | ||
| Mechanical ventilation | ||
| Redo transplant >1 year for obstructive chronic lung allograft dysfunction |