To be considered as a candidate for a lung transplant, you will first undergo a thorough transplant evaluation. The evaluation will help our transplant team learn more about you and your disease. This will give you the opportunity to learn more about our lung transplant team and program.
You will go through a series of consultations and tests during the evaluation. The transplant physicians will be looking for medical and/or psychosocial conditions that would affect the chances of a successful transplant. Evaluations are completed as either inpatient or outpatient.
Before you can be put on a waiting list for a lung transplant, the determination has to be made that there is no other treatment option available for your condition. In addition, it must be determined that you are capable of enduring the transplant process.
You will meet with a transplant coordinator, transplant surgeon, transplant pulmonologist, psychologist, social worker, transplant financial counselor and respiratory therapist during the transplant evaluation. These visits or appointments will help determine if there are special concerns that you and your family may have regarding the transplant and what type of support is needed for a successful transplant outcome.
The diagnostic tests are extensive but necessary to understand the complete medical status of the patient. These tests include those to analyze the general health of the body, particularly the heart and lungs, nutritional status, presence of an infection, and to ensure that the patient receives a donor organ that is a good match. The following are some of the other tests that may be performed, although many of the tests are decided on an individual basis:
- Blood tests - including blood type, tissue typing and viral studies.
- Urine tests.
- Echocardiogram - a procedure that evaluates the structure and function of the heart by using sound waves to produce a moving picture of the heart.
- Electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
- Cardiac catheterization - a diagnostic procedure in which a tiny, hollow tube (catheter) is guided through a vein or artery into the heart to image the heart and blood vessels. A colorless, liquid dye is given through the catheter and moving X-ray pictures are made as the dye travels through the heart.
- Lung biopsy - a procedure in which tissue samples are removed (with a needle or during surgery) from a lung for examination under a microscope.
- MUGA heart imaging - a nuclear scan to see how the heart walls move and how much blood is expelled with each heartbeat.
- Sputum culture - a diagnostic test performed on the material that is coughed up from the lungs and into the mouth. A sputum culture is often performed to determine if an infection is present.
- Pulmonary function tests - diagnostic tests which help to measure the lungs' ability to move air into and out of the lungs effectively. The tests are usually performed with special machines into which a patient must breathe.
- Chest computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the lungs. CT scans are more detailed than general X-rays.
- Cardiopulmonary exercise testing.
The transplant team will consider all information from interviews, a patient’s medical history, physical examination and diagnostic tests in determining whether a patient is a candidate for lung transplantation. If the patient has been accepted by the program to have a lung transplant, they will be placed on the Organ Procurement and Transplant Network (OPTN) waiting list.