**2.2.1 Major contraindications**

A history of malignancy during the past two years, except for skin cancers. In general 5 year disease free survival is expected (4).

Untreatable advanced disease of another organ system, except the heart, where a heart-lung transplantation could be considered.

Untreatable extra-pulmonary infections, including chronic, active viral hepatitis and HIV infection.

Significant chest deformity.

Unreliable social support, medical non-compliance or major psychiatric or psychological disorder.

Active substance abuse or use within the past 6 months.

#### **2.2.2 Relative contraindications**

Older age; older patients have less optimal survival following lung transplantation.

Critical or unstable conditions, such as Extra Corporeal Membrane Oxygenation or mechanical ventilation.

Severely limited functional class with poor rehabilitation potential.

Colonization with highly virulent or antibiotic resistant organism.

Obesity or malnutrition (BMI>30 or BMI<17).

Mechanical Ventilation except in carefully selected patients

Severe or untreated gastroesophageal reflux disease.
