For clinicians, the evaluation process for lung transplantation can be opaque, especially when patients are acutely ill and in the hospital. This session will review selection criteria, potential barriers and strategies for optimizing patients to prepare them for transplant evaluation. Specific areas that will be discussed include when to refer, what transplant programs are looking for when considering urgent inpatient transfers to transplant centers, advances in mechanical ventilation and ECMO as bridges to transplant and other cutting edge management approaches to rehabilitation, nutrition, body composition, and psychosocial evaluation. Attendees will gain insight into the referral and evaluation process and improved ability to collaborate with their local transplant centers. The goal is to give patients the best opportunity to become candidates for lung transplantation.