transplantineligible

Transplantineligible is a designation used in organ transplantation to describe patients who are considered not eligible to receive a transplant after formal evaluation. Eligibility is determined by a multidisciplinary team at a transplant center and is influenced by medical, psychosocial, and logistical factors. In some cases eligibility can be temporary, with re-evaluation after treating reversible conditions; in others it is permanent.

Common medical contraindications include active infections, unresectable or uncontrolled malignancy with poor prognosis, irreversible multi-organ failure or severe cardiopulmonary disease that makes transplant high risk or futile, profound malnutrition or frailty, and a limited life expectancy due to nontransplant disease. Additional factors such as nonadherence, ongoing substance use, or significant psychosocial instability can also render a patient ineligible, particularly if post-transplant care would be jeopardized. Decisions are individualized and consider available resources and alternative treatments.

Process and implications: Patients who are transplant-ineligible are not placed on the transplant waiting list. They may receive ongoing medical management, palliative care, or referral to other therapies or clinical trials. Some centers offer programs to address reversible issues (e.g., treating infections, achieving sobriety) with the goal of re-evaluating candidacy.

Ethical and policy considerations: Ineligibility criteria aim to balance patient safety, resource utilization, and expected benefit, but they can raise concerns about disparities and access. The term acknowledges that transplant decisions are complex and individualized.