A 68-year-old with idiopathic pulmonary fibrosis has FVC 50% predicted and desaturates to 82% during a six-minute walk despite optimal medical care.

Question

A 68-year-old with idiopathic pulmonary fibrosis has FVC 50% predicted and desaturates to 82% during a six-minute walk despite optimal medical care. Which advanced-care step is indicated?

Accepted Answer

Refer early for lung-transplant assessment while continuing antifibrotic and supportive management according to eligibility

Answer

Stop antifibrotic therapy because transplant assessment has begun and future prescribing will be transplant-centred

Answer

Use long-term systemic corticosteroid as disease-modifying monotherapy

Answer

Arrange lung-volume-reduction surgery because fibrotic restriction responds like emphysema

Answer

Wait until invasive ventilation is required because transplant referral before terminal failure is premature

IPF Transplant Referral — RACP Adult Medicine MCQ

A 68-year-old with idiopathic pulmonary fibrosis has FVC 50% predicted and desaturates to 82% during a six-minute walk despite optimal medical care. Which advanced-care step is indicated?