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Preparing for a Lung Transplant

There is a lot to plan for when getting ready to receive a transplant: patients undergo an evaluation phase, a waiting period, hospitalization for surgery, and continuing lifelong care after transplant surgery.

We provide a dedicated team of individuals to provide help and answer questions during each step of the process.

Your We partner with your local pulmonologist and or local primary physician remains the doctor you go to for routine care, and medications, medical emergencies or hospitalization until you receive your lung transplant. Once listed, we will be seeing you in our pre-transplant clinic in Gainesville, FL until your transplantation. you receive your transplant, our team becomes your primary care provider, responsible for all medical testing and/or follow-up care.

Transplant follow-up care is life-long and provided to you at our center in Gainesville.

Referring Physicians

Criteria for Lung Transplant Candidates

  • End-Stage Lung Disease with life expectancy less than 24-months
  • Younger than 74-years-old
  • Complete smoking/tobacco abstinence for at least 6-months
  • Ambulatory
  • BMI of 30 or less, and acceptable nourishment
  • No other major organ dysfunction
  • If history of cancer, must be at least 3-years post-therapy

What’s Needed to Refer a Patient

  • PFTs, CXR and/or Chest CT
  • History/Physical within past 12-months
  • Current height and weight
  • Smoking history and cessation date/year
  • Any other applicable testing (6 minute walk test, sputum culture for CF patients, Echo, Cardiac Cath, recent bloodwork)

Evaluation

The evaluation testing process is a series of assessments, interviews, and medical tests preformed as an outpatient over a 3 to 4 day period.

The evaluation is used to determine your candidacy for transplantation. In some cases, tests will need to be done early in the morning and at various times throughout the day. Some procedures, such as left heart catheterization, may require an overnight stay.

You will need to plan for oxygen use while you are in Gainesville. The hospital will allow you to use oxygen outlets during clinical testing, where available, but you need to bring enough tanks for traveling within the hospital and in your hotel room. If you are not sure what amount of oxygen to bring, ask your local oxygen provider to help you.

Your primary caregiver must accompany you during this process. A primary caregiver is someone who has been designated as your main support person and must be present for all aspects of the transplant process (pre- and post-transplant). This person will be responsible for many aspects of the process and will need to attend pre-transplant evaluation, attend clinic appointments, bring you to the hospital for the surgery, provide support while you are hospitalized, live with you in Gainesville for 10-12 weeks after transplant, and bring you to the clinic/hospital for lifelong follow-up visits and admissions.

During the evaluation phase, you will meet with our lung transplant team. What follows is a list of the assessments and testing to be done during your pre-transplant evaluation process. Depending on your diagnosis, additional tests may be added.


Evaluation Testing and Assessments

Lung Testing

  • Chest X-ray
  • Pulmonary Function Studies (tests breathing ability)
  • Ventilation-Perfusion Scan
  • Chest CT Scan

Heart Function Testing

  • Electrocardiogram (EKG)
  • Echocardiogram
  • Cardiac Catheterization (based on the results, you may be admitted overnight)
  • Carotid Ultrasound (if necessary, based on age)

Blood and Urine Testing

  • Complete Blood Count
  • Kidney Function Tests
  • Blood lipid (Fat) Profile
  • Urinalysis, 24-hour Urine Collection (as needed)
  • Blood Coagulation Profile
  • Liver Function Studies
  • Blood Type and Grouping
  • Antigen/Antibody/Tissue Typing
  • HIV Virus Test
  • Thyroid Function
  • Viral Illness Testing
  • Hepatitis Testing

Other

  • Abdominal Ultrasound
  • CT scan of abdomen and pelvis
  • Barium esophagram
  • 24 hour ph impedance and manometry testing
  • Bone Density
  • Ankle-Brachial Index (based on age & risk factors)
  • Carotid Ultrasound (based on age & risk factors)
  • Females: Mammogram and Pap Smear (may be done locally)

Physical Therapy Assessment

Your overall strength and endurance will be assessed. Staff will then provide recommendations and techniques to exercise safely and efficiently with advanced lung disease.

  • 6-minute walk
  • Endurance and strength testing

Psychosocial Assessment

You and your caregiver’s understandings of the transplant process and lifelong expectations after transplant will be investigated. This evaluation will assist our transplant team to develop a working relationship between you and your caregivers and help with communications. The evaluation will include -

  • A review of your caregiver plan
  • Discussion of resources (financial, fundraising, support, inner coping, etc.)
  • Identification of potential barriers to transplant
  • Transplant Education

Psychological Assessment

This assessment will measure patient’s and caregiver’s behavioral ability to successfully navigate transplant.


Financial Planning

Financial assessment and planning is based on your insurance coverage.


Pharmacy Planning

Medication assessment and planning is based on your insurance coverage.


Becoming a Candidate

After the evaluation process is complete, the transplant team will meet to discuss all the medical tests and assessments at the Medical Review Board (MRB). This selection committee meeting will determine whether you could be listed for transplant at our center.

If more medical testing is needed, we will work with you and/or your local physicians to make the necessary arrangements to complete these additional tests as quickly as possible. We will try to contact you within 24-hours of the MRB meeting informing you of the team decision. In case we are not able to list you for lung transplantation at our center, we will provide you with the reasons as to why we are not able to do so.


Waiting for your new lung

Waiting for a suitable lung to become available may be the toughest part of the transplantation process. Rest assured our team will do everything possible to help you get your new lung before there is any further deterioration in your status.

Recommended suggestions while you wait for your lung transplant include:

  • Talk about your feelings with your family and friends.
  • Keep the transplant team informed of your condition, including hospitalizations and change of medications.
  • Be accessible by phone (home phone and cell phone).
  • See your doctor(s) at UF Health as scheduled.
  • Maintain good eating habits and watch your weight.
  • Participate in a regular exercise program to maintain muscle strength, endurance, and to improve quality of life.
  • Remember that the transplant coordinator, social work and other team members are available to help you through the waiting period.

While you are at home during the waiting period, it is a good idea to plan for the day you are called to come to the hospital for the transplant. We suggest that you keep a packed suitcase ready for the day (or night) of your surgery. When preparing your bag, think about what clothes and personal articles you would like to have with you in the hospital (books, music, etc.). It is helpful to make a list of people and phone numbers you want to notify about the transplant. In addition, note the time and route you will use when coming to the hospital and where your family plans to stay while you are in the hospital.