In order to be considered for a lung transplant, your child must be evaluated by our multidisciplinary Lung Transplant team. The evaluation includes a series of tests to see how severe your child’s lung disease is. This time is also used to decide if a lung transplant is the best treatment for your child, or if there are other options for his condition. Additionally, we'll check to make sure that your child does not have any other problems that will prevent him from getting the best results from a transplant. We encourage you to ask questions about anything you do not understand.
During the evaluation phase you and your child will meet many different healthcare specialists. These specialists may include doctors, nurses, therapists, dietitians, social workers, psychologists, clergy and financial counselors. Each of these specialists will ask for information about you and your child as well as give you information about lung transplantation. Formal education will be provided for you and your family along all phases of transplantation by our transplant coordinators.
What to expect during the evaluation
Typically, we will evaluate your child for transplantation over the course of two to three days as an outpatient. In some cases, inpatient evaluations are performed. At the beginning of the evaluation process, your family is provided information about the evaluation process itself. You will also learn about the potential benefits and harms of receiving a lung transplant, and consent is obtained before proceeding with the evaluation.
Appropriate patient selection is critical to ensure a safe and effective lung transplantation. Patient selection criteria are used to identify factors that increase the risk of patient mortality or lead to shortened graft survival. These factors are assessed through a multidisciplinary evaluation process that is intended to provide a clear and consistent approach. Our multidisciplinary team will perform an extensive review of all your child's medical and surgical records, laboratory and diagnostic studies, and multiple consultations.
The following are laboratory tests that are included in the evaluation process:
- Your child's blood type
- Kidney, liver, and other vital organ function tests
- Serology studies
The following are diagnostic tests that are included in the evaluation process:
- Electrocardiogram (ECG or EKG)
- Cardiac catheterization
- Magnetic resonance imaging (MRI)
- Lung biopsy
- Sputum culture
- Pulmonary function tests
- Tuberculosis (TB) test
- Chest computed tomography scan of the lungs (also called a CT or CAT scan)
Once we have completed your child's evaluation, the pediatric lung transplantation team will meet to discuss your child’s need for a lung transplant, as well as any problems that could make transplantation too risky for your child. Sometimes, more tests may be needed to make a final decision about lung transplantation.
In addition to health issues, there may be psychosocial issues, such as family support, that need further resolution before lung transplantation. We will make all the necessary arrangements to complete these extra tests or resolve issues as quickly as possible. Our social workers and psychologist participate in your child's evaluation and play an important role in helping you and your family prepare for transplantation. Financial advisors are also available to help families and to work with insurance companies.