Indication for lung transplantation in advanced cystic fibrosis

Lung transplantation has become a valid therapeutic option for cystic fibro sis patients with end-stage lung disease. The indication for transplantatio n does not rely on strict criteria only but must be evaluated case by case. In particular, the dynamics of the clinical course need to be considered w ith regard to impaired physical performance, recurrent infections, decline ill pulmonary function and weight loss. Important risk factors are a poor n utritional status, osteoporosis, liver involvement, previous pleurodesis an d the occurrence of multiresistant bacteria. Management and assessment of c ystic fibrosis patients fur lung transplantation is complex. Therefore pati ents should be referred to specialised centres at an early stage.