Preparing for the Evaluation

Before you go in for your medical evaluation, there are several steps you should take to ensure you’re in the best possible position to be accepted as a transplant candidate:
  • Demonstrate compliance. For you to be an optimal candidate for lung transplantation, all your other organ systems have to be functioning adequately. Your transplant team will want to see a habit of compliance with your medical care. Make sure your physicals, vaccinations, and dental care are up to date. If you have comorbidities (other diseases in addition to your lung disease), take your medications as prescribed, keep follow-up healthcare appointments, and follow any recommended medical diets.
  • Exercise. Transplant centers require a minimum level of endurance, which can take time to build up. Get started on your plan now. If oxygen needs or access issues prevent you from enrolling in exercise programs at a gym, ask your healthcare provider if a referral for pulmonary rehabilitation is available to you. Always talk with your provider before beginning a new exercise routine.
  • Meet weight requirements. Studies demonstrate that outcomes are better when patients are at an ideal weight. All transplant centers have a minimum and maximum body mass index (BMI) for transplant. Maximum BMI criteria vary per center, but are usually 30-35. If you need to lose weight, focus on portion control and increasing your activity level. Ask your healthcare provider for referrals to a medical weight loss clinic or dietitian consultation.
  • Stay substance-free and tobacco-free. You must not use narcotics, THC, illicit drugs, or alcohol. You also must be tobacco-free (usually for at least six months) to begin a transplant evaluation. This includes nicotine replacement therapies like patches, gum, and vaping. The transplant team may test your blood at any time during the evaluation process.
  • Be up to date on all vaccinations.
  • Regular dental exam and cleanings.
  • Have a strong support system. Most centers require patients to identify two to three caregivers who can provide combined continual support during the pre and post-transplant period. Caregivers may be family members, friends, and neighbors, as long as they can drive and are willing to learn to help care for a transplant patient.

The Medical Evaluation:

Because lung transplant is a major procedure, the medical evaluation process is lengthy and complex. You’ll meet with members of a team including a transplant pulmonologist, transplant surgeon, nurse coordinator, psychologist, social worker, physical therapist, finance coordinator, and others. These meetings may take place during several visits that extend over weeks or months. Transplant centers want to ensure that the candidates they select will benefit from transplantation and have good long-term outcomes. The evaluation starts with assessing your pulmonary health to ensure that you’re sick enough to warrant transplantation. The evaluation also ensures that other organ systems such as your heart, kidney, and liver are healthy enough to tolerate surgery and post-transplant medical therapies. The evaluation team will also consider psychological health, your family and social support, motivation, and financial circumstances. You’ll take numerous tests, which may include:

  • Pulmonary function tests
  • Chest X-ray
  • CT scan of the chest
  • Cardiac stress test
  • Echocardiogram (to assess heart structure and function)
  • Cardiac catheterization (to make sure your coronary arteries are not “clogged”)
  • Bone mineral density test
  • Complete blood count (CBC)
  • Screening for infectious diseases such as tuberculosis, HIV, Hepatitis B, and Hepatitis C—if you have one of these diseases, it must be well-managed
  • Screenings for certain age-appropriate cancers (colon, prostate, breast cancer, cervical cancer, etc.)
  • Screening for gastroesophageal reflux (GERD) and effective esophageal movement
  • Blood type / Panel Reactive Antibodies (PRA)

    FINANCIAL RESOURCES

    Lung Transplant Foundation

    Financial resources and Transplant preparation information – Lung Transplant Foundation website https://lungtransplantfoundation.org/

    Second Wind Lung Transplant Association

    Second Wind is dedicated to improving the quality of life for lung transplant recipients, lung surgery candidates, people with related pulmonary concerns and their families, caregivers and friends by providing support, advocacy, education, information and guidance through a spirit of service, adding years to their lives and life to their years. www.2ndwind.org

    BEF / Lung Transplant Grant Program

    The BEF Lung Transplant Grant Program is one way the Foundation works to give back to people with CF in the here and now, by helping families pay for the expenses that are not covered by their insurance.  www.esiason.org/thriving-with-cf/transplant-grants 

    Patient Airlift Services

    Providing free medical flights to people who need to access medical care that may be too far to get to by car.  www.palservices.org 

    Help Hope Live

    Medical fundraising for the expense insurance doesn’t cover helphopelive.org

    T-shirt fundraising

    Sell custom t-shirts and take donations with no inventory, hassles or risk. bonfire.com/ or customink.com/fundraising/

    National Foundation for Transplants

    Providing fundraising expertise and advocacy for patients in need of an organ transplant transplants.org

    American Transplant Foundation

    For transplant recipients, we help patients to keep the organ that keeps them alive by providing assistance to cover delinquent insurance premiums to prevent loss of insurance coverage, medication co-payments during insurance gap periods, and/or changes to insurance provider. www.americantransplantfoundation.org

    Individual State Assistance

    Some state programs offer financial assistance to residents needing a transplant, including Rhode Island, Massachusetts, and Georgia. Check to see if there is a program specific to your state, too.

    DISCLAIMER AND ATTRIBUTION

    The OPTN Web site  and the United Network for Organ Sharing | UNOS | US Organ Transplantation offer a wealth of information about transplantation.

    This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

    Financial resources and Transplant preparation information – Lung Transplant Foundation website https://lungtransplantfoundation.org/