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IPF transplant referral — SCE Respiratory MCQ

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HardILDIPF transplant referralSCE Respiratory

A 69-year-old man with IPF diagnosed 4 months ago has FVC 58% predicted, TLCO 31% predicted and desaturates to 82% on a 6-minute walk. He is otherwise fit, independent and asks about future treatment options. What is the most appropriate management?

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Correct answer: BDiscuss early referral to a lung transplant centre alongside antifibrotic therapy

IPF with marked gas transfer impairment and exertional desaturation warrants early transplant discussion if there are no absolute contraindications, while antifibrotic therapy is considered according to eligibility. Waiting until very advanced decline may miss the transplant window. Prednisolone/azathioprine, sildenafil and age-based exclusion as stated are not appropriate disease-modifying strategies.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/