Cited by 821Transplantation: Methods and OutcomesOrgan Donation and TransplantationPulmonary Hypertension Research and Treatments

The DOI matches its Crossref record; 349 of the 363 references it cites were found in a registry or an index; 20 of the 40 sources its claims cite were checked for support.

Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation.

Open access

Abstract

Updated ISHLT consensus providing a framework for identifying candidates for lung transplantation and accounting for combinations of risk factors in candidacy selection.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.healun.2021.07.005

Cites

349 of 349 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

20 of 40 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured

  • Background

    The paper says the ESC/ERS pulmonary hypertension model uses a multiparametric assessment and avoids nonmodifiable criteria and variable weighting.

    “The ESC/ERS model also employs the assessment of risk using a multi-parametric comprehensive analysis of clinical variables.(284) Unlike REVEAL, this model avoids use of any non-modifiable criteria, and does not “weight” the variables according to their relative importance.”
    Quote in the paperNot yet classified1 of 1 sources checked
    • cites [284] Galiè, 2016, Eur Heart J source

      Section 6.2.4 calls for a multidimensional, comprehensive assessment, and section 6.2.5 says overall assessment should guide decisions when variables fall into different risk categories. The claim that the model avoids any nonmodifiable criteria is too absolute: both sections say age, sex, and other factors not affected by therapy can modify risk. The passages do not explicitly specify whether variables receive numerical weights. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Background

    The paper says lung transplantation has expanded worldwide because more donors and candidates are now acceptable, and that candidate selection has become more complex.

    “This trend reflects the expansion of acceptable donors and candidates made possible by clinical and scientific advances. Far fewer absolute contraindications for lung transplant candidacy exist now, compared to the time of publication of prior versions of this document, making the selection of candidates even more complex.”
    Quote in the paperNot yet classified1 of 3 sources checked
    • cites [2] Orens, 2006, International guidelines for the selection of lung transplant candidates: 2006 update—a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation, J Heart Lung Transplant source

      The introduction says advances in technology and medical knowledge prompted updated candidate-selection guidelines, and the Relative contraindications section allows consideration of some candidates previously treated more restrictively. But our copy does not state that lung transplantation expanded worldwide because more donors became acceptable, nor does it explicitly say there are far fewer absolute contraindications than in 1998 or that selection has become more complex for that reason. No page numbers are available in our copy. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [3] Maurer, 1998, International guidelines for the selection of lung transplant candidates, Transplantation source
    • cites [4] Weill, 2015, A consensus document for the selection of lung transplant candidates: 2014–an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation, J Heart Lung Transplant source
  • Finding

    The paper says frailty is linked to higher waitlist and post-transplant mortality, but frailty measures are not yet settled for listing decisions.

    “Frailty, defined as a generalized vulnerability to stressors resulting from the presence of multiple physiologic deficits, is associated with an increased risk of waitlist and post-transplant mortality.(51–53) However, frailty in lung transplant candidates is often attributable to advanced lung disease and may improve following transplant.”
    Quote in the paperNot yet classified2 of 3 sources checked
    • cites [51] Baldwin, 2017, Refining low physical activity measurement improves frailty assessment in advanced lung disease and survivors of critical illness, Ann Am Thorac Soc source

      The Results (page unavailable) link frailty measured with FFP-DASI to increased death or delisting among lung-transplant candidates. The Methods (page unavailable) say participants were censored at transplant, so this study does not support the post-transplant mortality claim. The Abstract says no gold-standard frailty measure exists, but the paper does not specifically address using frailty measures for listing decisions. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
    • cites [52] Singer, 2018, Frailty phenotypes and mortality after lung transplantation: a prospective cohort study, Am J Transplant source
    • cites [53] Singer, 2015, Frailty phenotypes, disability, and outcomes in adult candidates for lung transplantation, Am J Respir Crit Care Med source
  • Finding

    The paper says patients with CF remain at risk of short-term mortality even with improved outcomes, and risk rises after FEV1 falls below 30% predicted.

    “Despite improved overall outcomes, many individuals with advanced CF lung disease remain at risk of short-term mortality. A 2017 study demonstrated a 10% risk of death each year after reaching an FEV1 < 30%, with many patients dying soon after reaching this threshold.”
    Quote in the paperNot yet classified1 of 1 sources checked
    • cites [245] Ramos, 2017, Heterogeneity in survival in adult patients with cystic fibrosis with FEV1 < 30% of predicted in the United States, Chest source
  • Method

    The paper says patients must abstain from all tobacco and nicotine products before transplant, verified with serial testing.

    “Lung transplant candidates must demonstrate abstinence from use of all tobacco and nicotine products (including nicotine replacement therapy) prior to transplant (e.g. with serial nicotine and cotinine screening).(111)”
    Quote in the paperNot yet classified1 of 1 sources checked
    • cites [111] Hofmann, 2018, Smoking resumption after heart or lung transplantation: a systematic review and suggestions for screening and management, J Thorac Dis source

      The Introduction says candidates are normally required to be smoke-free before joining a thoracic-transplant waiting list. But the systematic-screening section recommends cotinine testing at post-transplant follow-ups, not serial nicotine and cotinine testing before transplant. The paper also says nicotine replacement therapy can be used in transplant recipients; it does not establish the claimed pre-transplant ban on all nicotine products. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Active infections are generally contraindications for transplantation.

    “Active infections are generally contraindications for transplantation.”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [3]

    The Infectious Disease Risk Factors section says B. cenocepacia infection may be considered an absolute contraindication at many centers. But it also says infection with multidrug-resistant organisms is no longer universally an absolute contraindication, and describes circumstances in which patients with other infections may receive a lung transplant. The source therefore supports concern about particular active infections, not the broad statement that active infections are generally contraindications. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • In cases of CF and non-CF bronchiectasis, the colonization of resistant bacteria progresses, thereby increasing mortality after surgery.

    “In cases of CF and non-CF bronchiectasis, the colonization of resistant bacteria progresses, thereby increasing mortality after surgery.”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [3]

    The Infectious Disease Risk Factors section associates B. cenocepacia with increased post-transplant mortality, and the Cystic Fibrosis section links resistant-organism colonization to decline or death before transplant. The copy does not establish that resistant-bacterial colonization progressively increases after surgery or that it increases post-transplant mortality across both CF and non-CF bronchiectasis. Page numbers were not available in the indexed passages. (LLM, conf=0.84)

    Experimental — accuracy not yet measured
  • COPD remains the most common indication for lung transplantation.

    “Although COPD remains the most common indication for lung transplantation”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [3]

    The Disease Specific Considerations section discusses COPD as an indication for lung transplantation, and the Other Indications section says the document addresses some of the most common indications. Neither passage says COPD is the single most common indication or compares its frequency with other diagnoses; page numbers were not available in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured
  • Transplantation is possible despite infections with non-tuberculous mycobacteria, non-aspergillus molds, and Burkholderia cepacia complex if accompanied by appropriate treatment.

    “transplantation is possible despite infections with non-tuberculous mycobacteria, non-aspergillus molds, and Burkholderia cepacia complex if accompanied by appropriate treatment [3,26-28].”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [3]

    The Infectious Disease Risk Factors sections support that these infections need not categorically rule out lung transplantation. But treatment alone is not presented as sufficient: the document calls for specialized-center management for M. abscessus and Burkholderia cepacia complex, and individualized candidacy decisions for non-aspergillus molds. Page numbers were not provided in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured
  • The BODE score is still the most important indicator, and along with FEV1 and the presence or absence of acute exacerbation determine whether transplantation is possible based on the presence or absence of evidence for pulmonary arterial hypertension.

    “the BODE score (body mass index, degree of airway obstruction, dyspnea, and exercise capacity score) is still the most important indicator, and along with it, FEV1 and the presence or absence of acute exacerbation determine whether transplantation is possible based on the presence or absence of evidence for pulmonary arterial hypertension (PAH), as summarized in Table 2 [3,42].”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [3]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

Citations

Cites

Flagged first, then by citations

14 of the 363 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Kulig, 2017, Interpretation of workplace tests for cannabinoids, J Med Toxicol, 13, 106, 10.1007/s13181-016-0587-z · DOI · Paper page

Cited by

Sorted by citations

Metadata

Authors
Leard, L. E., Holm, A. M., Valapour, M., Glanville, A. R., Attawar, S., Aversa, M., Campos, S. V., Christon, L. M., Cypel, M., Dellgren, G., Hartwig, M. G., Kapnadak, S. G., Kolaitis, N. A., Kotloff, R. M., Patterson, C. M., Shlobin, O. A., Smith, P. J., Solé, A., Solomon, M., Weill, D., Wijsenbeek, M. S., Willemse, B. W. M., Arcasoy, S. M., & Ramos, K. J.
Affiliations
  • University of California, San Francisco (US)
  • Oslo University Hospital (NO)
  • Cleveland Clinic (US)
  • St Vincent's Hospital Sydney (AU)
  • Krishna Institute of Medical Sciences (IN)
  • University of Toronto (CA)
  • Medical University of South Carolina (US)
  • Sahlgrenska University Hospital (SE)
  • Duke University (US)
  • University of Washington (US)
  • University of Pennsylvania (US)
  • Royal Papworth Hospital (GB)
  • Inova Fairfax Hospital (US)
  • Erasmus MC (NL)
  • University Medical Center Groningen (NL)
  • Columbia University (US)
Corresponding author
Leard, Lorriana E.
Venue
The Journal of Heart and Lung Transplantation
Publisher
Elsevier BV
Published
2021-11
Volume
40
Issue
11
Pages
1349-1379
ISSN
1053-2498 (ISSN-L)
OpenAlex
W3183806681
Cited by
821
References
363
Citations by year
2026: 170 · 2025: 181 · 2024: 186 · 2023: 176 · 2022: 97 · 2021: 11
FWCI
110.28
Type
journal article
Language
en
Open access
Locations
  • The Journal of Heart and Lung Transplantation (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
  • PubMed Central (acceptedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Funders
  • U.S. Department of Health and Human Services
  • Cystic Fibrosis Foundation
  • Boomer Esiason Foundation
  • Bristol-Myers Squibb
  • United Therapeutics Corporation
  • European Respiratory Society
  • Vertex Pharmaceuticals
  • Savara Pharmaceuticals
  • Galecto
  • ZonMw
  • Astellas Pharma
  • Lung Foundation Netherlands
  • National Institutes of Health
  • Health Resources and Services Administration
  • National Heart, Lung, and Blood Institute (K23HL138154)
Topics
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
Keywords
lung transplantation, transplant candidate selection, advanced lung disease, referral timing, transplant evaluation, transplant listing, transplant ethics, risk stratification, International Society for Heart and Lung Transplantation
MeSH terms
Contraindications, Cystic Fibrosis, Humans, Societies, Medical, Lung Transplantation, Patient Selection, Pulmonary Disease, Chronic Obstructive

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Statistics and arithmetic are recomputed, not judged.

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