354 To refer or not to refer?: ethical challenges of appropriate patient selection to obtain optimum survival and quality of life post lung transplant

Abstract

Objectives: We present a case study which raises several ethical issues as to refer or not to refer and seek discussion and debate within this session. Currently in the UK there are 321 patients on the active lung transplant list. With a shortfall of available suitable organs, not all patients will receive a transplant. Up to 1 in 6 patients on the active lung transplant list die or become too sick to receive a graft. Successful transplant can achieve a 60% survival to 5 years. Contraindications to transplant can be physical and or psychosocial. This limited supply highlights the responsibility of CF teams to have consensus on referring candidates that are most likely to benefit from receiving this limited resource. The CF team need to be honest with patients and give a realistic account of process, outcomes and survival before a referral is made.