icon showing high importanceTo ensure a smooth and expedited intake process: 

Please encourage your patient to call Mass General registration at 866-211-6588, Monday-Friday, 8:00 am to 5:00 pm ET.

Please submit the secure form below to refer your patient to a provider in the Lung Transplant Program at Massachusetts General Hospital. Be sure to submit the following required documents via fax: 617-726-2581:

  • Insurance coverage
  • Relevant office notes
  • Pulmonary function tests
  • Chest CT reports
  • Echocardiogram
  • Lab results (chemistry & hematology)

If you have any questions about a specific patient’s eligibility, please contact us to discuss further at MGHLungTransplant@mgb.org.

The presence of the following contraindications may affect eligibility for lung transplantation:

  • Lack of patient willingness
  • BMI > 35
  • Malignancy with high risk of recurrence
  • Stroke or acute coronary syndrome in past 30 days
  • Active tobacco use
  • Active TB or other uncontrolled infection
  • Liver or kidney failure with low likelihood of recovery

Please review and consider discussing further.

* indicates a required field.

Patient Information




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When to refer:
  • BODE index 5-6
  • PaCO2 > 50 mmHg
  • PaO2 < 60 mmHg
  • FEV1 < 25% of predicted
When to refer:
  • FEV1 < 50% predicted and rapidly declining
  • FEV1 < 40% predicted with markers of shortened survival
  • FEV1 < 40% predicted and > 2 exacerbations per year requiring intravenous antibiotics, or 1 exacerbation requiring positive pressure ventilation, regardless of FEV1
  • FEV1 < 30% predicted
  • 6MW distance < 400 meters
  • Concurrent pulmonary hypertension
  • Acute respiratory failure
  • Pneumothorax
  • Life threatening hemoptysis despite embolization
When to refer:
  • At time of diagnosis

When to refer:
  • Any O2 requirement
  • Dyspnea/impairment due to lung disease
  • FVC < 80% predicted
  • DLCO < 40% predicted

When to refer:
  • NYHA class III or IV despite escalating therapy
  • Use of parental pulmonary arterial hypertension therapy
  • Pulmonary veno-occlusive disease 
  • Pulmonary capillary hemangiomatosis



When to refer:
  • BODE index 5-6
  • PaCO2 > 50 mmHg
  • PaO2 < 60 mmHg
  • FEV1 < 25% of predicted
When to refer:
  • FEV1 < 50% predicted and rapidly declining
  • FEV1 < 40% predicted with markers of shortened survival
  • FEV1 < 40% predicted and > 2 exacerbations per year requiring intravenous antibiotics, or 1 exacerbation requiring positive pressure ventilation, regardless of FEV1
  • FEV1 < 30% predicted
  • 6MW distance < 400 meters
  • Concurrent pulmonary hypertension
  • Acute respiratory failure
  • Pneumothorax
  • Life threatening hemoptysis despite embolization
When to refer:
  • At time of diagnosis

When to refer:
  • Any O2 requirement
  • Dyspnea/impairment due to lung disease
  • FVC < 80% predicted
  • DLCO < 40% predicted

When to refer:
  • NYHA class III or IV despite escalating therapy
  • Use of parental pulmonary arterial hypertension therapy
  • Pulmonary veno-occlusive disease 
  • Pulmonary capillary hemangiomatosis



Referring Physician Information














Preferred Method of Communication

Physician Gateway is our secure online portal allowing real-time access to your patients’ medical record. Physician Gateway enables you to submit referrals for patients, monitor patient status and order imaging tests. 

To learn more or to enroll, please visit the Physician Gateway.