Once referred by your doctor to Baylor, a carefully coordinated set of tests will be scheduled to determine your candidacy. Testing generally begins within seven days of referral and the total testing time typically takes two and a half full days. These tests are performed at Baylor University Medical Center at Dallas. You will be counseled extensively about the process of transplantation and what to expect from lung function and quality of life after transplant. The Baylor team members with whom you will meet include transplant pulmonologists, surgeons and cardiologists on the medical staff, along with nutritionists, social workers, financial counselors and physical therapists, among others.
Patient Selection Process
Once you complete the full evaluation, your case will be presented to the Lung Transplant Selection Committee at Baylor, which includes all the members of the team with whom you met on your visits. If all criteria are met for transplantation, you are approved and “listed” for transplantation. Listing means that you are placed on the Baylor Dallas waiting list for transplant in conjunction with the United Network for Organ Sharing (UNOS), the governmental body that oversees all transplantation in the United States.
The UNOS network links all sources of potential donor organs and generates a list of potential donor/recipient matches. UNOS uses a standardized lung allocation score (LAS) to prioritize recipients for transplantation. Medical information, specific to each transplant candidate, such as lab values, test results and disease diagnosis, is input into the UNOS database, and your LAS determined. Lungs are then allocated to recipients according to the LAS, blood type and geographic matching between donor and recipient.
The time you will wait for a transplant is highly variable and difficult to predict and can range from days to years. Our team will continue to monitor your health regularly while on the transplant waitlist with frequent follow-up visits at Baylor Dallas.
Preparation & Transplant
Once listed, you must be in contact and available within a three-hour radius of Baylor Dallas for a donor offer. Our transplant coordinator will contact you and provide all instructions. If you live at a farther distance, our transplant coordinator may arrange private air transportation. During your pre-transplant clinic visits, your transplant coordinator will make sure that you and your family know what to expect immediately before and after surgery. During transplantation, your coordinator will deliver regular updates to your family.
For more detailed information, please consult the patient handbook.
Immediately after transplant, you will be brought to the intensive care unit where you typically stay for two days. You will have many tubes and drains after surgery that will be removed over the first few days after transplant. Your pain will be controlled with intravenous and oral pain medications. Physical therapy will begin immediately after surgery in the intensive care unit. Prior to discharge, you will be given a list of your medications and their importance and instructed how to appropriately take them. On average, you will be in the hospital for two weeks after transplant.
Once leaving the hospital, your lung transplant team will manage all aspects of your medical care for at least the first year after surgery. At these visits, blood tests, radiologic imaging and bronchoscopic (telescope into the windpipe) biopsies are performed routinely. These biopsies are performed on an outpatient basis to evaluate for rejection, a potential response of your body against the transplanted lung. Blood tests are performed to monitor the levels of your anti-rejection medications. After one year, we coordinate your medical care with your primary care physician or pulmonologist. Routine visits to Baylor Dallas will continue to be necessary throughout the remainder of your life. Visits become more spread out as time from transplant progresses.