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©2013 UpToDate ® Print Email Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation, continued Pulmonary disease Recommendations 1. Patients with the following respiratory conditions and severity are not candidates for kidney transplantation: Requirement for home oxygen therapy (Grade C) Uncontrolled asthma (Grade C) Severe cor pulmonale Severe chronic obstructive pulmonary disease (COPD)-pulmonary fibrosis or restrictive disease with any of the following parameters (Grade C): best forced expiratory volume in 1 s (FEV1) <25% predicted value PO2 room air <60 mmHg with exercise desaturation, SaO2 <90% >4 lower respiratory infections in the last 12 months moderate disease with evidence of progression 2. Patients with moderate COPD-pulmonary fibrosis or restrictive disease with any of the following parameters have a relative contraindication for kidney transplantation (Grade C): Best FEV1 25-50% of predicted value PO2 room air <60-70 mmHg Restrictive disease with exercise desaturation, SaO2 90% 3. Patients should be strongly encouraged to stop smoking before kidney transplantation. Patients who continue to smoke may be eligible for kidney transplantation with full informed consent regarding their increased risk (Grade C). 4. Children with bronchopulmonary dysplasia, pulmonary hypoplasia or other significant chronic lung disease should be evaluated for transplantation in consultation with a pediatric respirologist (Grade C). * The strength of evidence supporting each recommendation was graded using the system developed by the Canadian Task Force on Preventive Health Care as follows: Grade A - There is good evidence to support Grade B - There is fair evidence to support Grade C - The existing evidence is conflicting, but other factors may influence decision-making Grade D - There is fair evidence to recommend against Grade E - There is good evidence to recommend against Reproduced with permission from: Knoll, G, Cockfield, S, Blydt-Hansen, T, et al. Canadian Society of Transplantation: Consensus guidelines on eligibility for kidney transplantation. CMAJ 2005; 173:S1. Copyright © 2005 CMA Media Inc.