end stage pulmonary disease end stage pulmonary disease end stage pulmonary disease (espd) is the result of chronic progressive lung diseases like copd, idiopathic pulmonary fibrosis, or systemic progressive diseases that affect the lungs such as cystic fibrosis or granulomatosis with polyangiitis. it is defined as when the lungs can no longer or barely remove enough carbon dioxide or supply enough oxygen to meet the body's basic needs. treatment incorporates a lung transplant. end stage pulmonary diseaseother namesend stage lung disease (esld)specialtypulmonology