Lung Transplant Evaluation Process at Tampa General Hospital
The lung transplant evaluation process at Tampa General Hospital consists of a series of appointments and tests that will help determine if a transplant procedure is the best form of treatment for you. Typically, your primary doctor or pulmonologist will refer you to our program for a lung transplant evaluation. The referral coordinator and pulmonologist will then review the referral and work together to schedule an initial consultation, when it then will be decided if you need a formal evaluation. If you are selected to receive a formal lung transplant evaluation at TGH, we will contact your insurance company to get authorization to conduct it.
During the lung transplant evaluation process, you will meet several times with our transplant team members. Evaluations may occur as inpatient or outpatient appointments, and most take between three and five days to complete. A family member or close friend should accompany you to all appointments and tests, and you should bring all of your medicines to each evaluation appointment. Additionally, during each visit you should wear comfortable clothes and walking shoes, bring money for food and drinks, and bring a book or magazine as you will have time to wait between tests.
Potential patients for every TGH transplant program must undergo blood tests, an echocardiogram, an electrocardiogram, scans and X-rays of the spine and hips (and potentially a bone density scan), and a cancer screening, and must complete all routine health care requirements prior to undergoing the transplant procedure. Specific information regarding the necessity for these tests and the specific health care requirements can be found here.
Furthermore, the evaluation process for lung transplant patients includes many other assessments that also will help us determine if a transplant is the most effective treatment for you. Those tests include:
- VO2 stress test – Your blood pressure, oxygen level, and heart activity will be measured as you walk on a treadmill. This will help your doctors test your overall pulmonary function and understand the exercise limitations caused by your lung disease.
- Carotid Doppler ultrasound – This non-invasive test uses sounds waves to measure blood flow through the large carotid arteries that supply blood to your brain. This test is performed during your lung transplant evaluation because it can help doctors determine stroke risk and the need for preventive measures.
- Barium swallow – This diagnostic test, performed after you drink a barium solution, involves a series of X-rays of the esophagus, stomach, and duodenum. It helps physicians check for reflux disease, which can increase the risk of infection or rejection after a lung transplant.
- VQ scan – This medical imaging test uses scintigraphy and medical isotopes to evaluate the circulation of air and blood within your lungs in order to determine a ventilation/perfusion ratio.
- Ultrasound of blood vessels – This test is used to look for blocked vessels, blood clots, and other problems.
- Left heart catheterization – This test checks for blocked arteries in your heart. An angiogram may also be performed during the lung transplant evaluation if one has not been performed previously.
- Right heart catheterization – Performed by inserting a small tube (catheter) in a vein in your neck, this test will provide measurements of the pressures in your heart and the blood vessels in your lungs. If pressures are high, intravenous medicines may be given to see if the pressures improve, as high pressures can cause a new lung to fail after transplant.
- Mantoux skin test – This is used to determine if you have ever been exposed to tuberculosis. If you have ever received a positive Mantoux skin test prior to your lung transplant evaluation, please make us aware.
- Pulmonary function tests – These special breathing tests measure your lung function and how well oxygen passes into the blood.
- Six-minute walk – Performed on a treadmill, this test measures the distance you can walk on a flat, hard surface and reflects your ability to perform daily physical activities.
Following this battery of tests during your lung transplant evaluation, the the transplant center team will meet to discuss the test results with our Medical Review Board, which includes the healthcare providers you worked with throughout the evaluation process. You are not permitted to attend this meeting.
If you meet the lung transplant requirements, the transplant coordinator will notify you, and we will seek authorization from your insurance company to perform the procedure. If you do not qualify for a transplant, or you choose not to undergo the procedure, your doctors will discuss other options for treatment based on the results of your lung transplant evaluation.