TEXAS CHILDREN'S PEDIATRIC LUNG TRANSPLANT PROGRAM
Transplant evaluation process

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Step 1
The first step in consideration for lung transplantation is communication.

In most cases, a pediatric specialist involved in the care of a candidate child will contact one of the team's transplant pulmonologists, nurse practitioners or transplant coordinators to obtain information or to make a referral. One of our pediatric lung transplant coordinators will contact a parent or guardian to outline the process of evaluation.

Step 2
Next the child's physician will provide information about the child’s condition, demographic and insurance information, representative X-rays (if needed), and other medical information. Additionally our team strongly recommends a social work family evaluation report.

Step 3
The third step is to gain approval from the family’s insurer for the evaluation. Some national insurers may not include Texas Children's Hospital as a center of excellence. Our staff is always willing to work with insurers, and a contract can usually be written. If you are a referring physician or an inquiring family, do not take "no" for an answer. Let Texas Children's financial consultants be advocates for your child and family with your insurer.

Step 4
The fourth step is scheduling the evaluation. Most children are evaluated over a 3-day period, within weeks of referral, as outpatients. The testing can be intense, but little of it involves pain for the child. Testing includes pulmonary function testing, a variety of X-ray studies, and echocardiography for most patients.

Our team tailors the schedule of tests according to the age, health and diagnosis of the child. We strongly recommend that both parents and grandparents attend the evaluation. The summary interview on the third day is the most critical time for family members to attend if circumstances do not permit them to be present for all three days.

Please note we leave some flexibility in our schedule for urgently referred patients.

Step 5
The fifth step is the evaluation. We will try to get results of recent CT scans, echocardiograms and other such tests from the referring physician to minimize duplicate testing. We will send a schedule of the testing needed to families prior to their arrival. 

The evaluation includes:

• Pulmonary function testing for clinically stable children 5 years of age or older

• Evaluation by a pediatric dietitian, social worker, child psychologist and child life specialist

• Evaluation by a physical therapist, which includes a six-minute walk test

• A clinic visit with a transplant pulmonologist on the first day and a more extended summary interview with the pulmonologist on the third day

• Blood work to assess kidney, renal, immunologic, and infectious disease status

• Blood typing

Most families will meet with one of our transplant surgeons during the evaluation as well.