Lung Transplant Considerations

Once your doctor has referred you to a lung transplant center, the transplant program will review your medical history to determine if they feel you have a good chance of being a transplant candidate. Sadly, there are more people that need lungs than there are lungs available. The transplant center wants to be sure that if you get lungs, you have the best chance of success. If they feel your medical background would make you a good candidate, they will invite you to be evaluated for a lung transplant. (See section on transplant evaluation).

Each transplant center is different. Some are willing to accept higher risk patients than others.

Here are some of the things the transplant program will look at in your medical history.

Specific risks for HPS:

• Risk of bleeding – While we have proven that people with HPS can successfully undergo a lung transplant, centers will be interested in learning about the bleeding of HPS, your history and how they will be able to control bleeding.
• Gastrointestinal problems – Transplant centers will want to know if you have active gastrointestinal problems and what medications you use to keep your symptoms under control. After the transplant, you will have to take medications that affect your immune system. They will want to be sure that medications you need won’t interfere with your transplant medications.
• Renal function – Transplant centers will want to be sure your kidneys are up to handling the stress of the transplant.
• Skin Cancer – Some types of skin cancer simply need to be treated before you are evaluated. For more serious forms of skin cancer, you will need to be cancer free for a specified period of time.
• High number of Patient Reactive Antibody (PRA) due to multiple blood/platelet transfusion.

General Risks:

• Lung functionality – There is a window of opportunity to get a lung transplant. If your lungs are still too healthy, the center may ask you to wait to undergo an evaluation until your lung disease has progressed further. If your lungs are too sick, you may not be able to tolerate the tests during the evaluation.
• General health – The transplant center will want to know about your general health, and any other health problems you may have not related to HPS, such as diabetes. They want to be sure that none of these problems will interfere with your new lungs. They also want to know ahead of time about any issues that might need to be managed along the way so that your journey is successful.
• Age and weight – These criteria vary among transplant centers. All, however, will be interested in your weight. They will want you to be at a healthy weight so that your surgery is successful. If you are not at a healthy weight, they may want you to demonstrate that you can lose weight before they evaluate you for a transplant.
• Nutrition – Good nutrition is important for healing.

Non medical issues

• Health insurance – Does your insurance cover transplant-related expenses at the transplant center? Not all insurance covers lung transplants. Some insurance coverage will only pay expenses at specified transplant centers. Save yourself some valuable time by checking this out yourself.
• Medication coverage – Do you have medication coverage that will cover your post-transplant medications?
• Finances – Can you afford the expenses associated with a lung transplant that are not covered by insurance.  If not, are you able to find other resources to help?
• Medical treatment compliance – To keep your new lungs healthy, you will have to follow instructions from the transplant team precisely. A history of not taking medications as instructed, or not following through on instructions from your doctors will be a concern for a transplant center.
• Family and community support – Getting a lung transplant is a long and very difficult process. You can’t do it alone. They will want to know if you have the support of others to help you along the way.