lung
Lung Home Patient InformationTransplant Evaluation
Your primary doctor or pulmonologist may refer you for evaluation if your lung function is very low (determined by a pulmonary function test) and he or she thinks no other medical or surgical therapy will help you. Your medical records will be sent to us to review. If an evaluation is necessary, you will come for an outpatient visit with the transplant pulmonologist and nurse coordinator. During this visit, you will be interviewed, examined and counseled about what we think is the best plan for your care. This may or may not include full evaluation for lung transplantation. The realities of having and living with a lung transplant are explained and discussed. If it is decided to proceed with more evaluation, an additional 2-3 days of inpatient testing is needed. Occasionally, outpatient testing is appropriate.
Tests
The evaluation consists of meeting many different people who will perform different tests. Tests may include:
- VQ scan (ventilation/perfusion lung scan)
- Chest X-ray (CXR)
- Chest CT (computed tomography)
- Six-minute walk
- EKG (electrocardiogram)
- Abdominal ultrasound
- Bone density scan
- Pulmonary function test (PFT)
- Echocardiogram
- Heart catheterization
- Blood work
- Urine collection
- Psychological evaluation
Meeting the Team
It is important that you meet all the members of the lung transplant team during the patient evaluation. Each brings special knowledge that will help you during all phases of the transplant process. The transplant team reviews the results of your evaluation. A plan of care is presented to you for consideration. This may or may not include the next step towards transplantation – being placed on the waiting list for a donor lung or lungs.
Transplant Surgeon
The transplant surgeon will perform your lung transplant surgery and will be in charge of your care immediately following your surgery. The transplant surgeon will also follow your progress as needed after you are discharged from the hospital.
Transplant Pulmonologist
The transplant pulmonologist will provide overall supervision of your medical care and, while you are on the waiting list, should be kept informed of your condition and consulted by your local pulmonologist. He or she may see you occasionally during your waiting time and, for the first few months after transplant, will see you routinely to perform bronchoscopies, adjust your medications and monitor your progress.
You will see the transplant pulmonologist less frequently as time goes by except when you experience problems. A pulmonologist is available 24 hours a day for urgent problems that may occur after hours. Once you have returned home, your local physicians need to be aware of your transplant and consult the transplant pulmonologist as needed.
Transplant Coordinator
The transplant coordinator is a bachelor’s or master’s-prepared registered nurse who is specially trained to care for patients before and after lung transplantation. The coordinator will help arrange your evaluation, teach you and your family about transplantation and follow your progress in the hospital and at each clinic visit after you are discharged. She will help answer your questions and provide support to you and your family.
Social Worker
A social worker is available for supportive counseling for you and your family during this challenging and stressful time. If you need information about local housing, fund-raising and other transplant resources, the transplant social worker will assist you.
Financial Coordinator
The financial coordinator will help you understand the cost of transplantation and your insurance benefits. He or she can answer questions about insurance coverage and help you contact the appropriate personnel regarding these questions.
Cardiologist
Transplant cardiologists may meet with you to evaluate your cardiac function.
Psychiatrist
A psychiatrist will meet with you to obtain a general mental health history. He or she may recommend counseling to deal with emotional needs or issues, such as depression, or alcohol, drug or tobacco use, that might affect the outcome of the transplant.
A psychiatrist will be available for any developing needs.
Psychiatric Clinical Nurse Specialist
The psychiatric clinical nurse specialist works with you and your family on issues such as stress, anxiety, depression and addiction. The psychiatric clinical nurse specialist will see you and your family during your initial evaluation, while you are in the hospital and as needed after you are discharged.
Clinical Nutritionist
Our clinical nutritionist will see you before and after your transplant to evaluate your diet and to help you maintain a healthy weight and healthy lungs. After your transplant, it is not uncommon to have difficulty maintaining your weight and blood cholesterol levels. Eating a balanced low-fat diet is very important, but can be challenging at times. The nutritionist will be available to see you regularly after transplant to discuss these issues.
Pharmacist
The transplant pharmacist may begin working with you the day you transfer to the surgery floor. It is important for you to clearly understand your medications and how each affects your body. The pharmacist will explain the actions, dosages and side effects of your medications. The pharmacist will be available during each hospitalization and by phone to answer questions about your medications.
Physical Therapist
A physical therapist may help pre-transplant patients understand what exercises are prescribed by the transplant pulmonologist. He or she is specially trained to help you regain your strength after surgery and will refer you to a pulmonary rehabilitation program in the early weeks after transplant. Exercise is important to your recovery. It can reduce complications after transplant surgery, improve your endurance and help you maintain a healthy lifestyle.
Chaplain
Transplantation often poses many spiritual issues. A chaplain will visit with you while you are at Emory Hospital and is on call 24 hours a day. The chaplain can help you and your family deal with conflicting emotions and difficult spiritual questions that are often associated with transplantation.
Staff Nurses
Staff nurses are responsible for monitoring your day-to-day progress as well as maximizing your environment for a smooth recovery. They will teach you how to monitor your vital signs, look for signs and symptoms of infection and care for your incision once you go home.