There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (n = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex-smokers with a body mass index (BMI) of <32 kg/m2 (n = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999-12/2021, n = 541), all patients who underwent transplantation for pulmonary fibrosis (n = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient's medical records (n = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety-six patients were referred to the transplant center, 50% (n = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.

Department of Lung Diseases and Tuberculosis University Hospital Brno Jihlavska 20 625 00 Brno Czech Republic

Department of Lung Diseases and Tuberculosis University Hospital Olomouc Zdravotniku 248 7 779 00 Olomouc Czech Republic

Department of Pneumology and Allergology Kromeriz Hospital a s Havlickova 660 767 01 Kromeriz Czech Republic

Department of Pneumology and Phthisiology AGEL Nový Jicin Purkynova 16 741 01 Novy Jicin Czech Republic

Department of Pneumology and Phthisiology University Hospital Plzen Edvarda Benese 13 300 01 Plzen Czech Republic

Department of Pulmonary Diseases and Tuberculosis of the Ostrava University Hospital and MF OU 17 Listopadu 5 708 00 Ostrava Czech Republic

Department of Respiratory Medicine 2nd Faculty of Medicine of Charles University and Motol University Hospital 5 Uvalu 84 150 06 Prague Czech Republic

Department of Respiratory Medicine of the 1st Faculty of Medicine of Charles University and Thomayer University Hospital Videnska 800 140 00 Prague Czech Republic

Department of Respiratory Medicine of the University Hospital Hradec Kralove Sokolska 581 500 05 Hradec Kralove Czech Republic

Department of Respiratory Medicine University Hospital Bulovka Budinova 67 2 180 00 Prague Czech Republic

Institute of Biostatistics and Analysis Masaryk University Brno Krenova 72 602 00 Brno Czech Republic

Pulmonary Department Masaryk Hospital Usti nad Labem Socialni pece 3316 12a 400 11 Ústí nad Labem Czech Republic

Pulmonary Department of Jihlava Hospital Vrchlickeho 4630 59 586 01 Jihlava Czech Republic

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