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Ann Thorac Surg 2000;69:S343-S357
© 2000 The Society of Thoracic Surgeons

Congenital Heart Surgery Nomenclature and Database Project: end-stage lung disease

J. William Gaynor, MDa, Nancy D. Bridges, MDb, Thomas L. Spray, MDa

a Division of Pediatric Cardiothoracic Surgery, The Cardiac Center at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
b Division of Pediatric Cardiology, The Cardiac Center at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

Address reprint requests to Dr Gaynor, Division of Pediatric Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, 34th & Civic Center Blvd, Suite 8527, Philadelphia, PA 19104
e-mail: gaynor{at}email.chop.edu

Presented at the International Nomenclature and Databases Conferences for Pediatric Cardiac Surgery, Chicago, Illinois, 1998–1999.

Abstract

The extant nomenclature for end-stage lung disease is reviewed for the purpose of establishing a unified reporting system. The subject was debated and reviewed by members of the STS-Congenital Heart Surgery Database Committee and representatives from the European Association for Cardiothoracic Surgery. All efforts were made to include all relevant nomenclature categories, using synonyms where appropriate. Indications for lung transplantation are coded under a broad category called pulmonary failure. The proposed hierarchical scheme also allows classification of complications of lung transplantation under a category called status post lung transplant. A comprehensive database set is presented which is based on a hierarchical scheme. Data are entered at various levels of complexity and detail, which can be determined by the clinician. These data can lay the foundation for comprehensive risk stratification analyses. A minimum database set is also presented, which will allow for data sharing and would lend itself to basic interpretation of trends. Outcome tables relating diagnoses, procedures, and various risk factors are presented.

I. Background

Significant numbers of lung and combined heart-lung transplants have been performed in children with end-stage cardiopulmonary disease for about 10 years [1–9]. These procedures are utilized in children with a wide range of diseases that result in end-stage pulmonary dysfunction. The most common indications for pediatric lung or heart-lung transplantation are cystic fibrosis, and pulmonary vascular disease with or without congenital heart disease. However, there are in addition a relatively large number of other diagnoses that may lead to lung transplantation in infants and children, and these disorders can not be encompassed by any existing diagnostic hierarchy. The proposed diagnostic hierarchy, therefore, consists of a listing of diseases for which lung transplantation may be applied. Indications for lung transplantation are coded under a broad category called pulmonary failure. When an indication for lung transplantation coexists with congenital heart disease, the congenital heart defect should be coded as a second diagnosis. The proposed hierarchical scheme also allows classification of complications of lung transplantation that may necessitate additional operative interventions, under a category called status post lung transplant.

The proposed classification of surgical procedures for lung transplantation includes the various types of lung and heart-lung transplantation that may be performed, including cadaveric lobar transplantation, living donor transplantation, and repeat transplantation. In addition, these patients frequently undergo a wide range of thoracic surgical and transcatheter procedures (bronchoscopy, balloon dilation, pulmonary resection, lung biopsy, etc), which must be included in the coding hierarchy. Some children undergo cardiac repair in association with lung transplantation and the cardiac procedure should be coded as a second procedure. A coding hierarchy for thoracic organ procurement is also presented.

II. Analysis: a unified end stage lung disease nomenclature system

End-stage lung disease hierarchy level 1

Pulmonary failure
Status post lung transplant

End-stage lung disease hierarchy level 2

Pulmonary failure, NOS

Pulmonary failure, Pulmonary parenchymal disease
Pulmonary failure, Pulmonary vascular disease
Pulmonary failure, Congenital heart disease without pulmonary hypertension (Specify heart defect as second diagnosis)
Pulmonary failure, Bronchiolitis obliterans
Pulmonary failure, Graft dysfunction

Status post lung transplant, NOS

Status post lung transplant, Indication for surveillance biopsy
Status post lung transplant, Indication for follow-up of previous biopsy
Status post lung transplant, Graft dysfunction
Status post lung transplant, Rejection
Status post lung transplant, Bronchiolitis obliterans
Status post lung transplant, Infection
Status post lung transplant, Hypoxemia
Status post lung transplant, Anastomotic complication
Status post lung transplant, Persistent air leak
Status post lung transplant, Other

End-stage lung disease hierarchy level 3

Pulmonary failure, NOS
Pulmonary failure, Pulmonary parenchymal disease, NOS

Pulmonary failure, Pulmonary parenchymal disease, Cystic fibrosis
Pulmonary failure, Pulmonary parenchymal disease, Bronchopulmonary dysplasia
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis
Pulmonary failure, Pulmonary parenchymal disease, Alpha 1 antitrypsin deficiency
Pulmonary failure, Pulmonary parenchymal disease, Adult Respiratory Distress Syndrome
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia
Pulmonary failure, Pulmonary parenchymal disease, Near drowning
Pulmonary failure, Pulmonary parenchymal disease, Other (Specify)

Pulmonary failure, Pulmonary vascular disease, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature
Pulmonary failure, Pulmonary vascular disease, Other (Specify)

Pulmonary failure, Congenital heart disease without pulmonary hypertension (Specify heart defect as second diagnosis)
Pulmonary failure, Bronchiolitis obliterans, NOS

Pulmonary failure, Bronchiolitis obliterans, Native lung
Pulmonary failure, Bronchiolitis obliterans, Transplanted lung

Pulmonary failure, Graft dysfunction, NOS

Pulmonary failure, Graft dysfunction, Secondary to rejection
Pulmonary failure, Graft dysfunction, Secondary to infection
Pulmonary failure, Graft dysfunction, Secondary to aspiration
Pulmonary failure, Graft dysfunction, Other (Specify)

Status post lung transplant, NOS
Status post lung transplant, Indication for surveillance biopsy
Status post lung transplant, Indication for follow-up of previous biopsy
Status post lung transplant, Graft dysfunction
Status post lung transplant, Rejection
Status post lung transplant, Bronchiolitis obliterans
Status post lung transplant, Infection, NOS

Status post lung transplant, Infection, Pulmonary infiltrate
Status post lung transplant, Infection, Empyema

Status post lung transplant, Hypoxemia
Status post lung transplant, Anastomotic complication, NOS

Status post lung transplant, Anastomotic complication, Arterial
Status post lung transplant, Anastomotic complication, Bronchial
Status post lung transplant, Anastomotic complication, Tracheal
Status post lung transplant, Anastomotic complication, Venous

Status post lung transplant, Persistent air leak, NOS

Status post lung transplant, Persistent air leak, Bronchopleural fistula
Status post lung transplant, Persistent air leak, Parenchymal

Status post lung transplant, Other

End-stage lung disease hierarchy level 4

Pulmonary failure, NOS
Pulmonary failure, Pulmonary parenchymal disease, NOS
Pulmonary failure, Pulmonary parenchymal disease, Cystic fibrosis
Pulmonary failure, Pulmonary parenchymal disease, Bronchopulmonary dysplasia
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, NOS

Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Idiopathic
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Surfactant protein deficiency
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Other (Specify)

Pulmonary failure, Pulmonary parenchymal disease, Alpha 1 antitrypsin deficiency
Pulmonary failure, Pulmonary parenchymal disease, ARDS
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, NOS

Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, Aspiration
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, Other

Pulmonary failure, Pulmonary parenchymal disease, Near drowning
Pulmonary failure, Pulmonary parenchymal disease, Other (Specify)
Pulmonary failure, Pulmonary vascular disease, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Primary
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary vein stenosis
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Left-sided cardiac disease (Specify heart defect as second diagnosis)
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Extrinsic compression of pulmonary veins
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary venoocclusive disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Other (Specify)

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Chronic obstructive pulmonary disease (COPD)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Interstitial lung disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Sleep disorder breathing
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Alveolar hypoventilation disorders
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Chronic exposure to high altitude
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Alveolar-capillary dysplasia
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Cystic adenoid malformation
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Other (specify)

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of proximal pulmonary arteries
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Inflammatory
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Pulmonary capillary hemangiomatosis

Pulmonary failure, Pulmonary vascular disease, Other (Specify)
Pulmonary failure, Congenital heart disease without pulmonary hypertension (Specify heart defect as second diagnosis)
Pulmonary failure, Bronchiolitis obliterans, NOS
Pulmonary failure, Bronchiolitis obliterans, Native lung
Pulmonary failure, Bronchiolitis obliterans, Transplanted lung
Pulmonary failure, Graft dysfunction, NOS
Pulmonary failure, Graft dysfunction, Secondary to rejection
Pulmonary failure, Graft dysfunction, Secondary to infection
Pulmonary failure, Graft dysfunction, Secondary to aspiration
Pulmonary failure, Graft dysfunction, Other (Specify)
Status post lung transplant, NOS
Status post lung transplant, Indication for surveillance biopsy
Status post lung transplant, Indication for follow-up of previous biopsy
Status post lung transplant, Graft dysfunction
Status post lung transplant, Rejection
Status post lung transplant, Bronchiolitis obliterans
Status post lung transplant, Infection, NOS
Status post lung transplant, Infection, Pulmonary infiltrate
Status post lung transplant, Infection, Empyema
Status post lung transplant, Hypoxemia
Status post lung transplant, Anastomotic complication, NOS
Status post lung transplant, Anastomotic complication, Arterial, NOS

Status post lung transplant, Anastomotic complication, Arterial, Stricture
Status post lung transplant, Anastomotic complication, Arterial, Dehiscence

Status post lung transplant, Anastomotic complication, Bronchial, NOS

Status post lung transplant, Anastomotic complication, Bronchial, Stricture
Status post lung transplant, Anastomotic complication, Bronchial, Dehiscence

Status post lung transplant, Anastomotic complication, Tracheal, NOS

Status post lung transplant, Anastomotic complication, Tracheal, Stricture
Status post lung transplant, Anastomotic complication, Tracheal, Dehiscence

Status post lung transplant, Anastomotic complication, Venous, NOS

Status post lung transplant, Anastomotic complication, Venous, Stricture
Status post lung transplant, Anastomotic complication, Venous, Dehiscence

Status post lung transplant, Persistent air leak, NOS
Status post lung transplant, Persistent air leak, Bronchopleural fistula
Status post lung transplant, Persistent air leak, Parenchymal
Status post lung transplant, Other

End-stage lung disease hierarchy level 5

Pulmonary failure, NOS
Pulmonary failure, Pulmonary parenchymal disease, NOS
Pulmonary failure, Pulmonary parenchymal disease, Cystic fibrosis
Pulmonary failure, Pulmonary parenchymal disease, Bronchopulmonary dysplasia
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, NOS
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Idiopathic
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Surfactant protein deficiency
Pulmonary failure, Pulmonary parenchymal disease, Pulmonary fibrosis, Other (Specify)
Pulmonary failure, Pulmonary parenchymal disease, Alpha 1 antitrypsin deficiency
Pulmonary failure, Pulmonary parenchymal disease, ARDS
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, NOS
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, Aspiration
Pulmonary failure, Pulmonary parenchymal disease, Pneumonia, Other
Pulmonary failure, Pulmonary parenchymal disease, Near drowning
Pulmonary failure, Pulmonary parenchymal disease, Other (Specify)
Pulmonary failure, Pulmonary vascular disease, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Primary, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Primary, Sporadic
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Primary, Familial

Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Congenital cardiac disease (Specify heart defect as second diagnosis)
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Collagen vascular disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Portal hypertension
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Drug or toxin induced (Specify)
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Persistent pulmonary hypertension of the newborn (persistent fetal circulation) (PFC)
Pulmonary failure, Pulmonary vascular disease, Pulmonary arterial hypertension, Secondary, Other (Specify)

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary vein stenosis, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary vein stenosis, Congenital
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary vein stenosis, Acquired

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Left-sided cardiac disease (Specify heart defect as second diagnosis)
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Extrinsic compression of pulmonary veins, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Extrinsic compression of pulmonary veins, Fibrosing mediastinitis
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Extrinsic compression of pulmonary veins, Adenopathy / Tumor

Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Pulmonary venoocclusive disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary venous hypertension, Other (Specify)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Chronic obstructive pulmonary disease (COPD)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Interstitial lung disease
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Sleep disorder breathing
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Alveolar hypoventilation disorders
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Chronic exposure to high altitude
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease, Congenital diaphragmatic hernia (CDH)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease, Meconium aspiration
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease, Persistent pulmonary hypertension of the newborn (persistent fetal circulation) (PFC)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Neonatal lung disease, Perinatal asphyxia

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Alveolar-capillary dysplasia
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Cystic adenoid malformation
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension associated with diseases of the respiratory system, Other (specify)
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of proximal pulmonary arteries
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Pulmonary embolism-NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Pulmonary embolism-Thrombus
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Pulmonary embolism-Tumor
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Pulmonary embolism-Parasite
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Pulmonary embolism-Foreign material
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, In situ thrombosis
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to chronic thromboembolic disease, Obstruction of distal pulmonary arteries, Sickle cell disease

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, NOS
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Inflammatory, NOS

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Inflammatory, Schistosomiasis
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Inflammatory, Sarcoidosis
Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Inflammatory, Other (Specify)

Pulmonary failure, Pulmonary vascular disease, Pulmonary hypertension due to disorders directly affecting the pulmonary vasculature, Pulmonary capillary hemangiomatosis
Pulmonary failure, Pulmonary vascular disease, Other (Specify)
Pulmonary failure, Congenital heart disease without pulmonary hypertension (Specify heart defect as second diagnosis)
Pulmonary failure, Bronchiolitis obliterans, NOS
Pulmonary failure, Bronchiolitis obliterans, Native lung
Pulmonary failure, Bronchiolitis obliterans, Transplanted lung
Pulmonary failure, Graft dysfunction, NOS
Pulmonary failure, Graft dysfunction, Secondary to rejection
Pulmonary failure, Graft dysfunction, Secondary to infection
Pulmonary failure, Graft dysfunction, Secondary to aspiration
Pulmonary failure, Graft dysfunction, Other (Specify)
Status post lung transplant, NOS
Status post lung transplant, Indication for surveillance biopsy
Status post lung transplant, Indication for follow-up of previous biopsy
Status post lung transplant, Graft dysfunction
Status post lung transplant, Rejection
Status post lung transplant, Bronchiolitis obliterans
Status post lung transplant, Infection, NOS
Status post lung transplant, Infection, Pulmonary infiltrate
Status post lung transplant, Infection, Empyema
Status post lung transplant, Hypoxemia
Status post lung transplant, Anastomotic complication, NOS
Status post lung transplant, Anastomotic complication, Arterial, NOS
Status post lung transplant, Anastomotic complication, Arterial, Stricture
Status post lung transplant, Anastomotic complication, Arterial, Dehiscence
Status post lung transplant, Anastomotic complication, Bronchial, NOS
Status post lung transplant, Anastomotic complication, Bronchial, Stricture
Status post lung transplant, Anastomotic complication, Bronchial, Dehiscence
Status post lung transplant, Anastomotic complication, Tracheal, NOS
Status post lung transplant, Anastomotic complication, Tracheal, Stricture
Status post lung transplant, Anastomotic complication, Tracheal, Dehiscence
Status post lung transplant, Anastomotic complication, Venous, NOS
Status post lung transplant, Anastomotic complication, Venous, Stricture
Status post lung transplant, Anastomotic complication, Venous, Dehiscence
Status post lung transplant, Persistent air leak, NOS
Status post lung transplant, Persistent air leak, Bronchopleural fistula
Status post lung transplant, Persistent air leak, Parenchymal
Status post lung transplant, Other

III. Nomenclature for end stage lung disease treatment options

End-stage lung disease treatment hierarchy level 1

Transplant, Lung(s)
Transplant, Heart and lung(s)
Pulmonary resection
Bronchoscopy
Transcatheter intervention
Thoracic procedure

End-stage lung disease treatment hierarchy level 2

Transplant, Lung, NOS

Transplant, Lung, Single (Left)
Transplant, Lung, Single (Right)
Transplant, Lung, Bilateral (Sequential)
Transplant, Lung, Double (en bloc)

Transplant, Heart and lung(s), NOS

Transplant, Heart and lung(s), Heart/Double lung
Transplant, Heart and lung(s), Heart/Left lung
Transplant, Heart and lung(s), Heart/Right lung

Pulmonary resection

Pulmonary resection, Pneumonectomy
Pulmonary resection, Lobectomy
Pulmonary resection, Bilobectomy
Pulmonary resection, Segmental lung resection
Pulmonary resection, Wedge resection

Bronchoscopy, NOS

Bronchoscopy, Flexible
Bronchoscopy, Rigid
Bronchoscopy, Flexible and rigid

Transcatheter intervention, NOS

Transcatheter intervention, Arterial dilation
Transcatheter intervention, Venous dilation
Transcatheter intervention, Arterial stent
Transcatheter intervention, Venous stent
Transcatheter intervention, Vessel occlusion
Transcatheter intervention, Defect Creation
Transcatheter intervention, Defect occlusion

Thoracic procedure, NOS

Thoracic procedure, Open lung biopsy
Thoracic procedure, Revision of anastomosis
Thoracic procedure, Drainage of effusion
Thoracic procedure, Drainage of empyema
Thoracic procedure, Drainage of pneumothorax
Thoracic procedure, Closure of bronchopleural fistula
Thoracic procedure, Pleurodesis
Thoracic procedure, Other

End-stage lung disease treatment hierarchy level 3

Transplant, Lung, NOS
Transplant, Lung, Single (Left), NOS

Transplant, Lung, Single (Left), Cadaveric lung
Transplant, Lung, Single (Left), Cadaveric lobe
Transplant, Lung, Single (Left), Living donor-related lobe
Transplant, Lung, Single (Left), Living donor-not related lobe

Transplant, Lung, Single (Right), NOS

Transplant, Lung, Single (Right), Cadaveric lung
Transplant, Lung, Single (Right), Cadaveric lobe
Transplant, Lung, Single (Right), Living donor-related lobe
Transplant, Lung, Single (Right), Living donor-not related lobe

Transplant, Lung, Bilateral (Sequential), NOS

Transplant, Lung, Bilateral (Sequential), Cadaveric lung
Transplant, Lung, Bilateral (Sequential), Cadaveric lobe
Transplant, Lung, Bilateral (Sequential), Living donor-related lobe
Transplant, Lung, Bilateral (Sequential), Living donor-not related lobe

Transplant, Lung, Double (en bloc)
Transplant, Heart and lung(s), NOS
Transplant, Heart and lung(s), Heart/double lung
Transplant, Heart and lung(s), Heart/left lung
Transplant, Heart and lung(s), Heart/right lung
Pulmonary resection
Pulmonary resection, Pneumonectomy, NOS

Pulmonary resection, Pneumonectomy, Left
Pulmonary resection, Pneumonectomy, Right

Pulmonary resection, Lobectomy, NOS

Pulmonary resection, Lobectomy, Left lower lobe
Pulmonary resection, Lobectomy, Left lower lobe
Pulmonary resection, Lobectomy, Right upper lobe
Pulmonary resection, Lobectomy, Right middle lobe
Pulmonary resection, Lobectomy, Right lower lobe

Pulmonary resection, Bilobectomy, NOS

Pulmonary resection, Bilobectomy, RUL and RML
Pulmonary resection, Bilobectomy, RML and RLL
Pulmonary resection, Bilobectomy, RUL and RLL

Pulmonary resection, Segmental lung resection, NOS

Pulmonary resection, Segmental lung resection, LUL apicoposterior segment
Pulmonary resection, Segmental lung resection, LUL anterior segment
Pulmonary resection, Segmental lung resection, LUL superior lingular segment
Pulmonary resection, Segmental lung resection, LUL inferior lingular segment
Pulmonary resection, Segmental lung resection, LLL superior segment
Pulmonary resection, Segmental lung resection, LLL anteromedial basal segment
Pulmonary resection, Segmental lung resection, LLL lateral basal segment
Pulmonary resection, Segmental lung resection, LLL posterior basal segment
Pulmonary resection, Segmental lung resection, LUL superior division (LUL anterior and LUL apicoposterior segmental resections)
Pulmonary resection, Segmental lung resection, LUL inferior division (LUL lingulectomy)
Pulmonary resection, Segmental lung resection, LUL posterior segment and LLL superior segment
Pulmonary resection, Segmental lung resection, LUL apicoposterior segment and LLL superior segment
Pulmonary resection, Segmental lung resection, LLL basal segments
Pulmonary resection, Segmental lung resection, RUL apical segment
Pulmonary resection, Segmental lung resection, RUL anterior segment
Pulmonary resection, Segmental lung resection, RUL posterior segment
Pulmonary resection, Segmental lung resection, RML lateral segment
Pulmonary resection, Segmental lung resection, RML medial segment
Pulmonary resection, Segmental lung resection, RLL superior segment
Pulmonary resection, Segmental lung resection, RLL medial basal segment
Pulmonary resection, Segmental lung resection, RLL anterior basal segment
Pulmonary resection, Segmental lung resection, RLL lateral basal segment
Pulmonary resection, Segmental lung resection, RLL posterior basal segment
Pulmonary resection, Segmental lung resection, RUL anterior and apical segments
Pulmonary resection, Segmental lung resection, RUL posterior segment and RLL superior segment
Pulmonary resection, Segmental lung resection, RLL basal segments
Pulmonary resection, Segmental lung resection, Other (Specify)

Pulmonary resection, Wedge resection, NOS

Pulmonary resection, Wedge resection, LUL
Pulmonary resection, Wedge resection, LUL-lingula
Pulmonary resection, Wedge resection, LLL
Pulmonary resection, Wedge resection, RUL
Pulmonary resection, Wedge resection, RML
Pulmonary resection, Wedge resection, RLL

Bronchoscopy, NOS
Bronchoscopy, Flexible, NOS

Bronchoscopy, Flexible, Diagnostic
Bronchoscopy, Flexible, BAL
Bronchoscopy, Flexible, Biopsy
Bronchoscopy, Flexible, Dilation
Bronchoscopy, Flexible, Laser

Bronchoscopy, Rigid, NOS

Bronchoscopy, Rigid, Diagnostic
Bronchoscopy, Rigid, BAL
Bronchoscopy, Rigid, Biopsy
Bronchoscopy, Rigid, Dilation
Bronchoscopy, Rigid, Laser
Bronchoscopy, Rigid, Stent placement
Bronchoscopy, Rigid, Stent removal
Bronchoscopy, Rigid, Stent repositioning

Bronchoscopy, Flexible and rigid
Transcatheter intervention, NOS
Transcatheter intervention, Arterial dilation, NOS

Transcatheter intervention, Arterial dilation, Left pulmonary artery
Transcatheter intervention, Arterial dilation, Right pulmonary artery
Transcatheter intervention, Arterial dilation, LPA segmental
Transcatheter intervention, Arterial dilation, RPA segmental
Transcatheter intervention, Arterial dilation, Other

Transcatheter intervention, Venous dilation, NOS

Transcatheter intervention, Venous dilation, Right pulmonary vein NOS
Transcatheter intervention, Venous dilation, Right upper pulmonary vein
Transcatheter intervention, Venous dilation, Right lower pulmonary vein
Transcatheter intervention, Venous dilation, Left pulmonary vein NOS
Transcatheter intervention, Venous dilation, Left upper pulmonary vein
Transcatheter intervention, Venous dilation, Left lower pulmonary vein
Transcatheter intervention, Venous dilation, Superior vena cava
Transcatheter intervention, Venous dilation, Other

Transcatheter intervention, Arterial stent, NOS

Transcatheter intervention, Arterial stent, LPA
Transcatheter intervention, Arterial stent, RPA
Transcatheter intervention, Arterial stent, LPA segmental
Transcatheter intervention, Arterial stent, RPA segmental
Transcatheter intervention, Arterial stent, Other

Transcatheter intervention, Venous stent, NOS

Transcatheter intervention, Venous stent, RPV NOS
Transcatheter intervention, Venous stent, RUPV
Transcatheter intervention, Venous stent, RLPV
Transcatheter intervention, Venous stent, LPV NOS
Transcatheter intervention, Venous stent, LUPV
Transcatheter intervention, Venous stent, LLPV
Transcatheter intervention, Venous stent, SVC
Transcatheter intervention, Venous stent, Other

Transcatheter intervention, Vessel occlusion, NOS

Transcatheter intervention, Vessel occlusion, Bronchial collateral
Transcatheter intervention, Vessel occlusion, Other

Transcatheter Intervention, Defect Creation, NOS

Transcatheter Intervention, Defect Creation, Atrial Septostomy

Transcatheter intervention, Defect occlusion, NOS

Transcatheter intervention, Defect occlusion, ASD
Transcatheter intervention, Defect occlusion, Other

Thoracic procedure, NOS
Thoracic procedure, Open lung biopsy, NOS

Thoracic procedure, Open lung biopsy, LUL
Thoracic procedure, Open lung biopsy, LUL-lingula
Thoracic procedure, Open lung biopsy, LLL
Thoracic procedure, Open lung biopsy, RUL
Thoracic procedure, Open lung biopsy, RML
Thoracic procedure, Open lung biopsy, RLL

Thoracic procedure, Revision of anastomosis, NOS

Thoracic procedure, Revision of anastomosis, Arterial
Thoracic procedure, Revision of anastomosis, Bronchial
Thoracic procedure, Revision of anastomosis, Tracheal
Thoracic procedure, Revision of anastomosis, Venous

Thoracic procedure, Drainage of effusion, NOS

Thoracic procedure, Drainage of effusion, Thoracocentesis
Thoracic procedure, Drainage of effusion, Tube thoracostomy
Thoracic procedure, Drainage of effusion, Open surgical drainage

Thoracic procedure, Drainage of empyema, NOS

Thoracic procedure, Drainage of empyema, Thoracocentesis
Thoracic procedure, Drainage of empyema, Tube thoracostomy
Thoracic procedure, Drainage of empyema, Open surgical drainage

Thoracic procedure, Drainage of pneumothorax, NOS

Thoracic procedure, Drainage of pneumothorax, Thoracocentesis
Thoracic procedure, Drainage of pneumothorax, Tube thoracostomy

Thoracic procedure, Closure of bronchopleural fistula, NOS

Thoracic procedure, Closure of bronchopleural fistula, Muscle flap

Thoracic procedure, Pleurodesis, NOS

Thoracic procedure, Pleurodesis, Mechanical
Thoracic procedure, Pleurodesis, Talc
Thoracic procedure, Pleurodesis, Bleomycin
Thoracic procedure, Pleurodesis, Doxycycline
Thoracic procedure, Pleurodesis, Tetracycline
Thoracic procedure, Pleurodesis, Other

Thoracic procedure, Other

End-stage lung disease treatment hierarchy level 4

Transplant, Lung, NOS
Transplant, Lung, Single (Left), NOS
Transplant, Lung, Single (Left), Cadaveric lung
Transplant, Lung, Single (Left), Cadaveric lobe
Transplant, Lung, Single (Left), Living donor-related lobe
Transplant, Lung, Single (Left), Living donor-not related lobe
Transplant, Lung, Single (Right), NOS
Transplant, Lung, Single (Right), Cadaveric lung
Transplant, Lung, Single (Right), Cadaveric lobe
Transplant, Lung, Single (Right), Living donor-related lobe
Transplant, Lung, Single (Right), Living donor-not related lobe
Transplant, Lung, Bilateral (Sequential), NOS
Transplant, Lung, Bilateral (Sequential), Cadaveric lung
Transplant, Lung, Bilateral (Sequential), Cadaveric lobe
Transplant, Lung, Bilateral (Sequential), Living donor-related lobe
Transplant, Lung, Bilateral (Sequential), Living donor-not related lobe
Transplant, Lung, Double (en bloc)
Transplant, Heart and lung(s), NOS
Transplant, Heart and lung(s), Heart/double lung
Transplant, Heart and lung(s), Heart/left Lung
Transplant, Heart and lung(s), Heart/right lung
Pulmonary resection
Pulmonary resection, Pneumonectomy, NOS
Pulmonary resection, Pneumonectomy, Left, NOS

Pulmonary resection, Pneumonectomy, Left, Completion pneumonectomy

Pulmonary resection, Pneumonectomy, Right, NOS

Pulmonary resection, Pneumonectomy, Right, Completion pneumonectomy

Pulmonary resection, Lobectomy, NOS
Pulmonary resection, Lobectomy, LUL
Pulmonary resection, Lobectomy, LLL
Pulmonary resection, Lobectomy, RUL
Pulmonary resection, Lobectomy, RML
Pulmonary resection, Lobectomy, RLL
Pulmonary resection, Bilobectomy, NOS
Pulmonary resection, Bilobectomy, RUL and RML
Pulmonary resection, Bilobectomy, RML and RLL
Pulmonary resection, Bilobectomy, RUL and RLL
Pulmonary resection, Segmental lung resection, NOS
Pulmonary resection, Segmental lung resection, LUL apicoposterior segment
Pulmonary resection, Segmental lung resection, LUL anterior segment
Pulmonary resection, Segmental lung resection, LUL superior lingular segment
Pulmonary resection, Segmental lung resection, LUL inferior lingular segment
Pulmonary resection, Segmental lung resection, LLL superior segment
Pulmonary resection, Segmental lung resection, LLL anteromedial basal segment
Pulmonary resection, Segmental lung resection, LLL lateral basal segment
Pulmonary resection, Segmental lung resection, LLL posterior basal segment
Pulmonary resection, Segmental lung resection, LUL superior division (LUL anterior and LUL apicoposterior segmental resections)
Pulmonary resection, Segmental lung resection, LUL inferior division (LUL lingulectomy)
Pulmonary resection, Segmental lung resection, LUL posterior segment and LLL superior segment
Pulmonary resection, Segmental lung resection, LUL apicoposterior segment and LLL superior segment
Pulmonary resection, Segmental lung resection, LLL basal segments
Pulmonary resection, Segmental lung resection, RUL apical segment
Pulmonary resection, Segmental lung resection, RUL anterior segment
Pulmonary resection, Segmental lung resection, RUL posterior segment
Pulmonary resection, Segmental lung resection, RML lateral segment
Pulmonary resection, Segmental lung resection, RML medial segment
Pulmonary resection, Segmental lung resection, RLL superior segment
Pulmonary resection, Segmental lung resection, RLL medial basal segment
Pulmonary resection, Segmental lung resection, RLL anterior basal segment
Pulmonary resection, Segmental lung resection, RLL lateral basal segment
Pulmonary resection, Segmental lung resection, RLL posterior basal segment
Pulmonary resection, Segmental lung resection, RUL anterior and apical segments
Pulmonary resection, Segmental lung resection, RUL posterior segment and RLL superior segment
Pulmonary resection, Segmental lung resection, RLL basal segments
Pulmonary resection, Segmental lung resection, Other (Specify)
Pulmonary resection, Wedge resection, NOS
Pulmonary resection, Wedge resection, LUL
Pulmonary resection, Wedge resection, LUL-lingula
Pulmonary resection, Wedge resection, LLL
Pulmonary resection, Wedge resection, RUL
Pulmonary resection, Wedge resection, RML
Pulmonary resection, Wedge resection, RLL
Bronchoscopy, NOS
Bronchoscopy, Flexible, NOS
Bronchoscopy, Flexible, Diagnostic
Bronchoscopy, Flexible, BAL (Bronchioalveolar lavage)
Bronchoscopy, Flexible, Biopsy
Bronchoscopy, Flexible, Dilation, NOS

Bronchoscopy, Flexible, Dilation, Left bronchus
Bronchoscopy, Flexible, Dilation, Right bronchus
Bronchoscopy, Flexible, Dilation, Trachea
Bronchoscopy, Flexible, Dilation, Left bronchial anastomosis
Bronchoscopy, Flexible, Dilation, Right bronchial anastomosis
Bronchoscopy, Flexible, Dilation, Tracheal anastomosis

Bronchoscopy, Flexible, Laser, NOS

Bronchoscopy, Flexible, Laser, Left bronchus
Bronchoscopy, Flexible, Laser, Right bronchus
Bronchoscopy, Flexible, Laser, Trachea
Bronchoscopy, Flexible, Laser, Left bronchial anastomosis
Bronchoscopy, Flexible, Laser, Right bronchial anastomosis
Bronchoscopy, Flexible, Laser, Tracheal anastomosis

Bronchoscopy, Rigid, NOS
Bronchoscopy, Rigid, Diagnostic
Bronchoscopy, Rigid, BAL (Bronchioalveolar lavage)
Bronchoscopy, Rigid, Biopsy
Bronchoscopy, Rigid, Dilation, NOS

Bronchoscopy, Rigid, Dilation, Left bronchus
Bronchoscopy, Rigid, Dilation, Right bronchus
Bronchoscopy, Rigid, Dilation, Trachea
Bronchoscopy, Rigid, Dilation, Left bronchial anastomosis
Bronchoscopy, Rigid, Dilation, Right bronchial anastomosis
Bronchoscopy, Rigid, Dilation, Tracheal anastomosis

Bronchoscopy, Rigid, Laser, NOS

Bronchoscopy, Rigid, Laser, Left bronchus
Bronchoscopy, Rigid, Laser, Right bronchus
Bronchoscopy, Rigid, Laser, Trachea
Bronchoscopy, Rigid, Laser, Left bronchial anastomosis
Bronchoscopy, Rigid, Laser, Right bronchial anastomosis
Bronchoscopy, Rigid, Laser, Tracheal anastomosis

Bronchoscopy, Rigid, Stent placement, NOS

Bronchoscopy, Rigid, Stent placement, Left bronchus
Bronchoscopy, Rigid, Stent placement, Right bronchus
Bronchoscopy, Rigid, Stent placement, Trachea
Bronchoscopy, Rigid, Stent placement, Left bronchial anastomosis
Bronchoscopy, Rigid, Stent placement, Right bronchial anastomosis
Bronchoscopy, Rigid, Stent placement, Tracheal anastomosis

Bronchoscopy, Rigid, Stent removal
Bronchoscopy, Rigid, Stent repositioning
Bronchoscopy, Flexible and rigid
Transcatheter intervention, NOS
Transcatheter intervention, Arterial dilation, NOS
Transcatheter intervention, Arterial dilation, LPA
Transcatheter intervention, Arterial dilation, RPA
Transcatheter intervention, Arterial dilation, LPA segmental
Transcatheter intervention, Arterial dilation, RPA segmental
Transcatheter intervention, Arterial dilation, Other
Transcatheter intervention, Venous dilation, NOS
Transcatheter intervention, Venous dilation, RPV NOS
Transcatheter intervention, Venous dilation, RUPV
Transcatheter intervention, Venous dilation, RLPV
Transcatheter intervention, Venous dilation, LPV NOS
Transcatheter intervention, Venous dilation, LUPV
Transcatheter intervention, Venous dilation, LLPV
Transcatheter intervention, Venous dilation, SVC
Transcatheter intervention, Venous dilation, Other
Transcatheter intervention, Arterial stent, NOS
Transcatheter intervention, Arterial stent, LPA
Transcatheter intervention, Arterial stent, RPA
Transcatheter intervention, Arterial stent, LPA segmental
Transcatheter intervention, Arterial stent, RPA segmental
Transcatheter intervention, Arterial stent, Other
Transcatheter intervention, Venous stent, NOS
Transcatheter intervention, Venous stent, RPV NOS
Transcatheter intervention, Venous stent, RUPV
Transcatheter intervention, Venous stent, RLPV
Transcatheter intervention, Venous stent, LPV NOS
Transcatheter intervention, Venous stent, LUPV
Transcatheter intervention, Venous stent, LLPV
Transcatheter intervention, Venous stent, SVC
Transcatheter intervention, Venous stent, Other
Transcatheter intervention, Vessel occlusion, NOS
Transcatheter intervention, Vessel occlusion, Bronchial collateral
Transcatheter intervention, Vessel occlusion, Other
Transcatheter Intervention, Defect Creation, NOS
Transcatheter Intervention, Defect Creation, Atrial Septostomy
Transcatheter intervention, Defect occlusion, NOS
Transcatheter intervention, Defect occlusion, ASD
Transcatheter intervention, Defect occlusion, Other
Thoracic procedure, NOS
Thoracic procedure, Open lung biopsy, NOS
Thoracic procedure, Open lung biopsy, LUL
Thoracic procedure, Open lung biopsy, LUL-lingula
Thoracic procedure, Open lung biopsy, LLL
Thoracic procedure, Open lung biopsy, RUL
Thoracic procedure, Open lung biopsy, RML
Thoracic procedure, Open lung biopsy, RLL
Thoracic procedure, Revision of anastomosis, NOS
Thoracic procedure, Revision of anastomosis, Arterial, NOS

Thoracic procedure, Revision of anastomosis, Arterial, Left
Thoracic procedure, Revision of anastomosis, Arterial, Right

Thoracic procedure, Revision of anastomosis, Bronchial, NOS

Thoracic procedure, Revision of anastomosis, Bronchial, Left
Thoracic procedure, Revision of anastomosis, Bronchial, Right

Thoracic procedure, Revision of anastomosis, Tracheal
Thoracic procedure, Revision of anastomosis, Venous, NOS

Thoracic procedure, Revision of anastomosis, Venous, Left
Thoracic procedure, Revision of anastomosis, Venous, Right

Thoracic procedure, Drainage of effusion, NOS

Thoracic procedure, Drainage of effusion, NOS, Left
Thoracic procedure, Drainage of effusion, NOS, Right

Thoracic procedure, Drainage of effusion, Thoracocentesis, NOS

Thoracic procedure, Drainage of effusion, Thoracocentesis, Left
Thoracic procedure, Drainage of effusion, Thoracocentesis, Right

Thoracic procedure, Drainage of effusion, Tube thoracostomy, NOS

Thoracic procedure, Drainage of effusion, Tube thoracostomy, Left
Thoracic procedure, Drainage of effusion, Tube thoracostomy, Right

Thoracic procedure, Drainage of effusion, Open surgical drainage, NOS

Thoracic procedure, Drainage of effusion, Open surgical drainage, Left
Thoracic procedure, Drainage of effusion, Open surgical drainage, Right

Thoracic procedure, Drainage of empyema, NOS

Thoracic procedure, Drainage of empyema, NOS, Left
Thoracic procedure, Drainage of empyema, NOS, Right

Thoracic procedure, Drainage of empyema, Thoracocentesis, NOS

Thoracic procedure, Drainage of empyema, Thoracocentesis, Left
Thoracic procedure, Drainage of empyema, Thoracocentesis, Right

Thoracic procedure, Drainage of empyema, Tube thoracostomy, NOS

Thoracic procedure, Drainage of empyema, Tube thoracostomy, Left
Thoracic procedure, Drainage of empyema, Tube thoracostomy, Right

Thoracic procedure, Drainage of empyema, Open surgical drainage, NOS

Thoracic procedure, Drainage of empyema, Open surgical drainage, Left
Thoracic procedure, Drainage of empyema, Open surgical drainage, Right

Thoracic procedure, Drainage of pneumothorax, NOS

Thoracic procedure, Drainage of pneumothorax, NOS, Left
Thoracic procedure, Drainage of pneumothorax, NOS, Right

Thoracic procedure, Drainage of pneumothorax, Thoracocentesis, NOS

Thoracic procedure, Drainage of pneumothorax, Thoracocentesis, Left
Thoracic procedure, Drainage of pneumothorax, Thoracocentesis, Right

Thoracic procedure, Drainage of pneumothorax, Tube thoracostomy, NOS

Thoracic procedure, Drainage of pneumothorax, Tube thoracostomy, Left
Thoracic procedure, Drainage of pneumothorax, Tube thoracostomy, Right

Thoracic procedure, Closure of bronchopleural fistula, NOS

Thoracic procedure, Closure of bronchopleural fistula, NOS, Left
Thoracic procedure, Closure of bronchopleural fistula, NOS, Right

Thoracic procedure, Closure of bronchopleural fistula, Muscle flap, NOS

Thoracic procedure, Closure of bronchopleural fistula, Muscle flap, Left
Thoracic procedure, Closure of bronchopleural fistula, Muscle flap, Right

Thoracic procedure, Pleurodesis, NOS

Thoracic procedure, Pleurodesis, NOS, Left
Thoracic procedure, Pleurodesis, NOS, Right

Thoracic procedure, Pleurodesis, Mechanical, NOS

Thoracic procedure, Pleurodesis, Mechanical, Left
Thoracic procedure, Pleurodesis, Mechanical, Right

Thoracic procedure, Pleurodesis, Talc, NOS

Thoracic procedure, Pleurodesis, Talc, Left
Thoracic procedure, Pleurodesis, Talc, Right

Thoracic procedure, Pleurodesis, Bleomycin, NOS

Thoracic procedure, Pleurodesis, Bleomycin, Left
Thoracic procedure, Pleurodesis, Bleomycin, Right

Thoracic procedure, Pleurodesis, Doxycycline, NOS

Thoracic procedure, Pleurodesis, Doxycycline, Left
Thoracic procedure, Pleurodesis, Doxycycline, Right

Thoracic procedure, Pleurodesis, Tetracycline, NOS

Thoracic procedure, Pleurodesis, Tetracycline, Left
Thoracic procedure, Pleurodesis, Tetracycline, Right

Thoracic procedure, Pleurodesis, Other, NOS

Thoracic procedure, Pleurodesis, Other, Left
Thoracic procedure, Pleurodesis, Other, Right

Thoracic procedure, Other, NOS

Thoracic procedure, Other, Left
Thoracic procedure, Other, Right

Important modifiers for end-stage lung disease treatment: hierarchy level 1

Transplant sequence, Initial transplant
Transplant sequence, Retransplant

Important modifiers for end-stage lung disease treatment: hierarchy level 2

Transplant sequence, Initial transplant
Transplant sequence, Retransplant, NOS

Transplant sequence, Retransplant, Second transplant
Transplant sequence, Retransplant, Third transplant
Transplant sequence, Retransplant, Fourth transplant
Transplant sequence, Retransplant, Fifth or greater transplant

Organ procurement hierarchy level 1

Organ Procurement

Organ procurement hierarchy level 2

Organ Procurement, NOS

Organ Procurement, Heart
Organ Procurement, Lung(s)
Organ Procurement, Heart and lung(s)

Organ procurement hierarchy level 3

Organ Procurement, NOS
Organ Procurement, Heart
Organ Procurement, Lung(s), NOS

Organ Procurement, Lung(s), Left lung
Organ Procurement, Lung(s), Right lung
Organ Procurement, Lung(s), Bilateral
Organ Procurement, Lung(s), Lobe

Organ Procurement, Heart and lung(s), NOS

Organ Procurement, Heart and lung(s), Heart and bilateral lungs
Organ Procurement, Heart and lung(s), Heart and right lung
Organ Procurement, Heart and lung(s), Heart and left lung

Organ procurement hierarchy level 4

Organ Procurement, NOS
Organ Procurement, Heart
Organ Procurement, Lung(s), NOS
Organ Procurement, Lung(s), Left lung, NOS

Organ Procurement, Lung(s), Left lung, Brain death
Organ Procurement, Lung(s), Left lung, Nonheart beating

Organ Procurement, Lung(s), Right lung, NOS

Organ Procurement, Lung(s), Right lung, Brain death
Organ Procurement, Lung(s), Right lung, Nonheart beating

Organ Procurement, Lung(s), Bilateral, NOS

Organ Procurement, Lung(s), Bilateral, Brain death
Organ Procurement, Lung(s), Bilateral, Nonheart beating

Organ Procurement, Lung(s), Lobe, NOS

Organ Procurement, Lung(s), Lobe, Living-related
Organ Procurement, Lung(s), Lobe, Living-not related

Organ Procurement, Heart and lung(s), NOS
Organ Procurement, Heart and lung(s), Heart and bilateral lungs
Organ Procurement, Heart and lung(s), Heart and right lung
Organ Procurement, Heart and lung(s), Heart and left lung

IV. Diagnosis and procedure short lists

Diagnosis Short List
Lung disease, Benign
Lung disease, Malignant Pneumothorax
Pleural effusion
Empyema

Procedure Short List
Transplant, Lung(s)
Transplant, Heart and lung(s)
Lung biopsy
Lung procedure, Other
Bronchoscopy
Pleural drainage procedure

V. Database studies and outcome analysis

In addition to classification of the diagnosis and proceure, the minimal data set for these patients should include the patient and procedural variables that have been identified as essential data fields. The comprehensive data set should also include donor information such as age, sex, height, weight, blood type, Human Leucocyte antigen typing, and recipient data such as blood type, HLA typing, and panel reactive antibody (PRA) status. Procedural data should also be collected such as use of cardiopulmonary bypass, ischemic times for each organ, and the type of organ preservation utilized. Data should also be collected about immunosuppression including the type of initial immunosuppression, use of induction therapy, and type of long-term immunosuppression. Outcome reports would focus on operative mortality and length of survival stratified by the indications for transplantation and type of transplant as well as donor age, recipient age, donor sex, recipient sex, blood type, HLA typing, PRA status, graft ischemic times, use of induction therapy, type of immunosuppression, etc. Additional outcome variables of interest are the incidence of nonspecific early and late graft dysfunction, acute cellular rejection, bronchiolitis obliterans, and outcome following retransplantation.

References

  1. Bridges N.D., Spray T.L. Lung transplantation in children. Advances in cardiac surgery 1996;8:131-145.[Medline]
  2. Sweet S.C., Spray T.L., Huddleston C.B. Pediatric lung transplantation at St. Louis Children’s Hospital, 1990–1995. Am J Respir Crit Care Med 1997;155:1027-1035.[Abstract]
  3. Boucek M.M., Novick R.J., Bennett L.E., Fiol B., Keck B.M., Hosenpud J.D. The Registry of the International Society of Heart and Lung Transplantation. J Heart Lung Transplant 1998;16:1189-1206.
  4. Noyes B.E., Kurland G., Orenstein D.M., Fricker F.J., Armitage J.M. Experience with pediatric lung transplantation. J Pediatr 1994;124:261-268.[Medline]
  5. Balfour-Lynn I.M., Whitehead B.F., Rees P.G., Elliott M.J., de Leval M.R. Heart-lung transplantation for patients under 10 with cystic fibrosis. Arch Dis Child 1997;76:38-40.[Abstract/Free Full Text]
  6. Spray T.L., Mallory G.B., Canter C.E., Huddleston C.B., Kaiser L.R. Pediatric lung transplantation for pulmonary hypertension and congenital heart disease. Ann Thorac Surg 1992;54:216-225.[Abstract]
  7. Metras D., Shennib H., Kreitman B., Camboulives J., Viard L., Carcassonne M., Giudicelli R., Noirclerc M., Joint Marseille-Montreal Lung Transplant Program. Double-lung transplantation in children. Ann Thorac Surg 1993;55:352-357.[Abstract]
  8. Gaynor J.W., Bridges N.D., Clark B.J., Spray T.L. Update on lung transplantation in children. Curr Opin Pediatr 1998;10:256-261.[Medline]
  9. Starnes V.A., Barr M.L., Cohen R.G. Lobar transplantation. J Thorac Cardiovasc Surg 1994;108:403-411.[Abstract/Free Full Text]




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