Clinical Research Directory

Inclusion Criteria: Any patient who is undergoing double lung transplantation as part of the clinical program, consents for this prospective observational trial, and has one of the following conditions will be eligible. * Common Inclusion Criteria * Adults of Age ≦ 80 * Resistant or refractory to or without available standard of care treatment options or experimental treatment options that are known to increase survival outcome * Patients without any extrapulmonary disease * Patients with good general health with an ability to withstand physiologic stressors and undergo psychosocial evaluation by the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) or other assessment tools * Patients to meet all other criteria for lung transplantation including insurance approval and United Network for Organ Sharing (UNOS) registration Inclusion Criteria for Cohort A * Histologically confirmed selected lung non-small cell lung cancer including but not limited to: o according to the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification \- Lepidic dominant pattern * Adenocarcinoma in situ * Minimally invasive adenocarcinoma * Non mucinous lepidic predominant invasive adenocarcinoma o based on 2015 World Health Organization (WHO) classification of lung tumors including \- Invasive mucinous adenocarcinoma * Mixed invasive mucinous and mucinous adenocarcinoma * Colloid adenocarcinoma * Enteric adenocarcinoma * Minimally invasive adenocarcinoma * Nonmucinous * Mucinous \- Preinvasive lesions * Atypical adenomatous hyperplasia * Adenocarcinoma in situ * Nonmucinous * Mucinous * based on the 2004 WHO classification of lung tumors including - Bronchioloalveolar carcinoma * Nonmucinous * Mucinous * Mixed nonmucinous and mucinous or indeterminate * Without any distant metastasis confirmed by standard staging work-up * Without brain metastasis confirmed by brain imaging * Without unidentified primary site of cancer Inclusion Criteria for Cohort B * Metastatic cancers to lung alone - including but not limited to germ cell tumors, head \& neck tumors, colorectal tumors, renal cell tumors, testicular cancer * Without any other distant metastasis confirmed by standard staging work-up Inclusion Criteria for Cohort C * Respiratory failure with a history of cancer in the last 5 years - including, but not limited to interstitial lung disease (ILD), pulmonary fibrosis (idiopathic or secondary), advanced chronic obstructive pulmonary disease (COPD), bronchiectasis, emphysema, cystic fibrosis (CF), emphysema due to alpha-1 antitrypsin deficiency, and pulmonary arterial hypertension (PAH) * Without any other distant metastasis confirmed by standard staging work-up Exclusion Criteria: * Exclusion criteria * Adults unable or unwilling to consent * Individuals who are not yet adults (infants, children, teenagers) * Pregnant women * Prisoners * Vulnerable Populations * Presence of extrapulmonary disease or mediastinal nodal disease at the time of transplant referral * Small Cell Cancers * Unidentified primary site of cancer for Cohort A * Progression of disease or confirmed distant metastases or mediastinal nodal disease at any point during transplantation work-up * Medical ineligibility for lung transplantation after multidisciplinary assessment * Not a suitable candidate according to the lung transplantation protocol for treatment of lung confined primary or metastatic tumors * Body mass index more than 35 kg/m2 * Evidence of co-existing malignancies for Cohort A * Untreatable significant dysfunction of another major organ system including heart, liver, kidney, or brain unless combined organ transplantation can be performed * Uncorrected atherosclerotic disease with suspected or confirmed end-organ ischemia or dysfunction and/or coronary artery disease not amenable to revascularization * Uncorrectable bleeding diathesis * Evidence of active Mycobacterium tuberculosis infection * Significant chest wall or spinal deformity expected to cause severe restriction after transplantation