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Lung Transplant Patient Evaluation

Patient Evaluation for an Adult Lung Transplant

1. Patient Demographics:
   
2. Mandatory Laboratory Testing:
1. General lab: CBC, BMP, BNP, liver function tests, PT/INR, PTT, LDH, calcium, magnesium, and phosphorous.
   
2. Hepatitis Screening: Hepatitis Acute Panel, Hep B Surface Antibody, Hep B Core Antibody, Hep A Total Antibody.
   
3. Autoimmune Screening: Rheumatoid Factor, ANA, Alpha 1 Antitrypsin Level, Ferritin, TSH, Free T4.
   
4. Microbiology Screening: EBV serology panel, fungal serologies, UA, 24 hour urine for creatinine clearance, Toxoplasmosis Antibody, CMV Antibody IgG and IgM, Varicella zoster titer, Rubella titers, RPR screen, Herpes IgG and IgM, Sputum gram stain/culture & sensitivity/AFB/fungal/Nocardia.
   
5. Special Screening: PSA if ≥ 40 male, Pregnancy test if menstruating female, Stool guiac x 3 if ≥ 50, PPD w/ Controls, Pap Smear, HLA Tissue Typing & PRA, Type & Screen Antibody Crossmatch.
   

1. Mandatory Diagnostic Studies
   

1. CT scan of Chest without Contrast
   
2. CT scan of sinuses without contrast
   
3. CXR PA and Lateral
   
4. Abdominal ultrasound, including gallbladder
   
5. Renal Ultrasound
   
6. Barium swallow
   
7. Panorex of mouth
   
8. Bone Mineral Density
   
9. Mammography (generally for females age 40 or over) done within last 12 months
   
10. Colonoscopy
    
11. EGD (Upper GI Endoscopy)
    
12. VQ Scan w/ differential perfusion & shunt study
    
13. Complete PFTs w/ ABGs on room air
    
14. MIPs and MEPs
    

1. Immunizations:
   
1. PPD with controls (Candida)
   
2. Hep B series
   
3. Hep A vaccine
   
4. Influenza
   
5. Pneumovax
   

1. Consultations:
   
1. Transplant pulmonologist
   
2. Gastrointestinal
   
1. EGD/Colonoscopy and biopsy as indicated
   
2. 24 hr pH probe
   
3. Esophageal Manometry
   
3. Cardiology
   
1. 12 Lead EKG
   
2. 2 D Doppler Echocardiogram w/ PA pressures
   
3. Myocardial perfusion study w/ Dobutamine (≥ 40)
   
4. Carotid Doppler (≥ 50)
   
5. 6 Minute Walk, w/ oxygen titration prn sats < 90 percent
   
4. Gynecologic:
   
1. Pap smear
   
2. Pelvic exam
   
3. Mammography for females age 40 and over
   
5. Dental Clearance
   
6. Psychosocial:
   
1. Social worker interview
   
2. Psychologist/psychiatrist
   
3. Appropriate substance abuse intervention as indicated prior to listing.
   
7. Financial:
   
1. Screening by transplant financial coordinator
   
2. Clearance must be obtained prior to listing.
   
8. Transplant Surgery Consultation: all prospective candidates must be assessed by the designated transplant surgeon.
   

An informed consent is obtained.

More Information On Our Lung Transplant Surgery Program

• See our full lung transplant referral criteria list.
  
• See our lung transplant life expectancy statistics.
  
• Complete an online organ transplant referral form.
  
• Learn more about the Nazih Zuhdi Transplant Institute, watch patient videos and interviews with our transplant surgeons on our Transplant Channel