Lung Transplant: Screening and Evaluation
What is pre-transplant screening?
The pre-transplant screening is first performed to make sure a lung transplant is the right treatment for you. You will have a group meeting prior to starting all of your tests on your first day. It is important you attend this meeting, which will review the entire transplant process and risks of transplantation.
What happens before the pre-transplant screening?
Before your pre-transplant screening, a transplant coordinator will contact you and your doctor to gather important information about your medical condition. This information includes:
- Brief medical history, including medicines (especially blood thinners)
- Pulmonary function studies
- Computed tomography (CT) scan and/or chest X-ray, if performed in the last year
- Insurance information including your coverage for transplantation
Once this information is received, a transplant coordinator will contact you for a telephone interview to further discuss your medical history and lung disease.
What insurance information am I responsible for?
It is the responsibility of you and your referring doctor to have insurance approval in place for your screening appointment. Please notify your insurance company of your pre-transplant screening appointment with Cleveland Clinic’s Transplant Center. Make sure your insurance company will provide coverage for the pre-transplant screening. (Many insurance companies will only provide coverage at specified centers.)
More information about insurance coverage will be provided on the day of your pre-transplant evaluation appointment. You may also meet with a financial advisor to help guide you through the process.
What happens during the pre-transplant screening?
During the pre-transplant screening, you will have several X-rays, laboratory tests, and breathing tests (called spirometry tests) to make sure you are eligible for a lung transplant.
The spirometry tests provide information about the extent of your lung disease and how well your lungs function. The tests are not painful, but might be uncomfortable. You will also meet with a transplant pulmonologist (a staff doctor with extensive training and experience in lung disease and transplantation). The pulmonologist will ask you questions about your condition.
The screening generally lasts most of the day. If the results of the screening evaluation indicate you are eligible for a lung transplant, you will be scheduled for a pre-transplant evaluation and follow up visits.
What is a pre-transplant evaluation?
A pre-transplant evaluation includes a complete physical, meetings with members of the Lung Transplant Team, and a series of tests. The evaluation might take several visits.
The pre-transplant evaluation is performed to make sure you are physically able to undergo a transplant. The evaluation helps the Transplant Team identify and treat any potential problems before the transplant, as well as avoid potential complications after the transplant.
What happens on the day of my screening appointment?
Your screening appointment day will begin with a pre-meeting, series of breathing tests, discussion of your medical history and a physical examination. You will also meet with members of the Lung Transplant Team, including the pulmonologist, transplant coordinator, financial coordinator, and social worker.
You might have to answer similar questions with each team member. Please be patient. Although the questions are similar, each specialist is concerned with a specific aspect of your health and will gain a different perspective of your lung disease.
Who is the transplant social worker?
You might see a transplant social worker during your evaluation appointment. Social workers can provide personal support to you and your family throughout the transplantation process. Social workers also offer:
- Counseling regarding lifestyle changes
- Referrals to community and national agencies and support groups that offer both information and support to transplant patients
- Information about home care services
- Fundraising for your transplant expenses
Who is the financial advisor?
You will meet with a financial advisor who can review your insurance coverage for pre- and post-transplant expenses. The financial advisor also can provide information about Social Security disability, supplemental security income, Medicaid, and Medicare.
What testing will be done during the appointment?
Lab testing will be completed during your pre-transplant evaluation appointment. This testing will include a nicotine/cotinine blood level. This test indicates whether you are smoking, chewing tobacco or nicotine gum, using inhaled nicotine products, or are exposed to second-hand smoke. The International Guidelines for Lung Transplant Candidacy require a patient to be nicotine-free for 6 months before undergoing an evaluation for transplantation.